Common Surgical Problems of the Neonate

Question 1

2 main reasons why neonates get sick

Answer 1

premature

congenital abnormality

Question 2

how to know if bowel is dilated?

Answer 2

if bowel is bigger than the horizontal diameter of the vertebral column

Question 3

what happens in pneumoperitoneum?

Answer 3

hole in bowel causes air to escape to the outside

Question 4

x-ray features of pneumoperitoneum?

Answer 4

gas under the diaphragm makes the liver very dense

Question 5

signs of necrotising enterocolitis on XR

Answer 5

leaky bowel begins to move outward

mottled appearance

Question 6

what quadrant does NEC tend to present in?

Answer 6

RLQ

Question 7

obstruction is common in term/preterm babies

Answer 7

term

Question 8

name the 3 methods of obstruction

Answer 8

intraluminal obstruction
compressed from outside the lumen
something within the bowel wall

Question 9

what colour is baby’s first poo?

Answer 9

black (meconium)

Question 10

signs of atresia?

Answer 10

baby hasn’t defaecated in 48hrs

distended doughy abdomen

Question 11

the obstruction in malrotation is high/low

Answer 11

high

Question 12

meconium stuck in the bowel is called…

Answer 12

meconium ileus

Question 13

cause of meconium ileus?

Answer 13

quality of bowel secretions is abnormal

Question 14

what bowel problems are babies with CF at risk of?

Answer 14

meconium ileus

Question 15

what is the stepladder sign?

what is it present in?

Answer 15

gas-fluid distended small bowel loops that appear to be stacked on top of each other
small bowel obstruction

Question 16

what does atresia mean?

Answer 16

problem with the bowel wall

Question 17

signs of an inguinal hernia?

Answer 17

loss of the pubic line

Question 18

what happens in an inguinal hernia?

Answer 18

loop of bowel in the scrotum

Question 19

if there are more big loops in the stepladder sign, where is the obstruction likely to be located?

Answer 19

lower down

if there are only a few “steps”, it is likely to be higher

Question 20

colour of vomiting bile?

Answer 20

green like fairy liquid

Question 21

child vomiting green bile…

Answer 21

malrotation

Question 22

Ix child vomiting green bile

Answer 22

upper GI contrast XR and follow through

Question 23

most common presentation of malrotation in then newborn?

Answer 23

midgut volvulus

Question 24

XR presentation of malrotation

Answer 24

no C shaped loop of duodenum
midgut volvulus (white circle)

Question 25

longest distance in abdomen?

Answer 25

diagonally from caecum to end of duodenum