Common Surgical Problems of the Neonate Flashcards
2 main reasons why neonates get sick
premature
congenital abnormality
how to know if bowel is dilated?
if bowel is bigger than the horizontal diameter of the vertebral column
what happens in pneumoperitoneum?
hole in bowel causes air to escape to the outside
x-ray features of pneumoperitoneum?
gas under the diaphragm makes the liver very dense
signs of necrotising enterocolitis on XR
leaky bowel begins to move outward
mottled appearance
what quadrant does NEC tend to present in?
RLQ
obstruction is common in term/preterm babies
term
name the 3 methods of obstruction
intraluminal obstruction
compressed from outside the lumen
something within the bowel wall
what colour is baby’s first poo?
black (meconium)
signs of atresia?
baby hasn’t defaecated in 48hrs
distended doughy abdomen
the obstruction in malrotation is high/low
high
meconium stuck in the bowel is called…
meconium ileus
cause of meconium ileus?
quality of bowel secretions is abnormal
what bowel problems are babies with CF at risk of?
meconium ileus
what is the stepladder sign?
what is it present in?
gas-fluid distended small bowel loops that appear to be stacked on top of each other
small bowel obstruction
what does atresia mean?
problem with the bowel wall
signs of an inguinal hernia?
loss of the pubic line
what happens in an inguinal hernia?
loop of bowel in the scrotum
if there are more big loops in the stepladder sign, where is the obstruction likely to be located?
lower down
if there are only a few “steps”, it is likely to be higher
colour of vomiting bile?
green like fairy liquid
child vomiting green bile…
malrotation
Ix child vomiting green bile
upper GI contrast XR and follow through
most common presentation of malrotation in then newborn?
midgut volvulus
XR presentation of malrotation
no C shaped loop of duodenum midgut volvulus (white circle)
longest distance in abdomen?
diagonally from caecum to end of duodenum
