Congenital Defects of the Bowel Flashcards
dx: newborn unable to pass an nasogastric tube into stomach, choking with feeds, history of polyhydramnios
esophageal atresia
dx: 5 week old baby, conjugated hyperbilirubinemia, acholic stool, dark urine
biliary atresia
treatment for biliary atresia (3)
vitamin supplementation A, D, E, K; urso; ampicillin prophylaxis for cholangitis
malrotation: pathogenesis
narrow mesenteric base permits abnormal mobility of the small bowel, allowing the mesentery to twist –> midgut volvulus (entire mesentery can die)
dx and mechanism: “double bubble” on x-ray, polyhydramnios, bilious vomiting
duodenal atresia, failure of recanalization
congenital defects of bowel associated with Down syndrome
duodenal atresia, Hirschprung’s disease, anorectal malformations
dx: polyhydramnois, baby does not pass meconium, bilious emesis, distended abdomen
jejunoileal atresia
jejunoileal atresia: pathogenesis
in-utero vascular disruption –> ischemic necrosis of fetal intestine –> reabsorbed, leaving blind proximal and distal ends
dx: 2-yo baby with blood in diaper, afebrile
Meckel’s diverticulum
Meckel’s diverticulum: pathogenesis
true diverticulum of small bowel, results from failure of involution of the vitelline duct
rules of 2: what disease, what are the rules (4)?
Meckel’s diverticulum: occurs in 2% of population, 2 ft from the ileocecal valve, 2 inches in length, symptomatic by 2 years of age
dx: bilious emesis, distended abdomen, failure to pass meconium, enterocolitis
Hirschprung’s disease
Hirschprung’s disease: pathogenesis
congenital defect in intestinal innervation, RET mutations
where in GI tract is Hirschprung’s disease most common?
rectosigmoid colon
risk factors for necrotizing enterocolitis
premature, formula-fed, immature immune system (dysbiosis)
