Congenital diseases

Question 1

What is the most common GI congenital disease?

Peristence of what structure causes it?

Answer 1

Meckel’s diverticulum

Vitelline duct

Question 2

What age and sex does Meckel’s Diverticulum most commonly present in?

Answer 2

2 yrs old

Males

Question 3

Complications of Meckel’s diverticulum (3) and what do they cause

Answer 3

• Ulceration, perforation and heamorraghe (due to presence of gastric mucosa) -> rectal bleeding
• Diverticulitis -> appendicitis like symtptoms
• Obstruction

Question 4

How is symptomatic Meckel’s diverticulum treated?

Answer 4

Surgical removal

Question 5

What does the rules of 2 apply to and what is it?

Answer 5

Meckel’s Diverticulum

DIverticulum 
2% of population 
2 inches long
2 feet from ileocecal valve
2 yo
2x more likely in males

Question 6

What is atresia?

Answer 6

Congenital absence or abnormal closure of a body cavity

Question 7

Name 3 types of atresia associated with the GI tract and one distinguishing feature of each

Answer 7

Oesophageal - swallowing/breathing difficulties
Intestinal - green (bile) vomit + signs of obstruction
Biliary - post hepatic jaundice

Question 8

What is meconium ileus?

What condition is this most commonly associated with?

Answer 8

Intestinal obstruction caused by meconium that is difficult to pass as is too sticky

CF

Question 9

What is omphalocele?

Answer 9

Intestinal loop does not return into abdo during development and instead herniates out into umbilical cord

Shiny sac at base of umblicial cord

Question 10

How would you treat congeintal GI diseases?

Answer 10

Surgery

Question 11

What is the main differnce between ompalocele and gastroschisis?

Answer 11

Omphalocele - intestines covered by a layer of peritoneum

Gastroschisis - intestines not covered by a layer of peritoneum

Question 12

Difference between volvulus and malrotation

Which can present in anyone and which is more likely in younger children (<1 yo)

Answer 12

Volvulus

• intestines wrapped around its own mesentery
• present in anyone

Malrotation

• congenital abnormality where intestines are twisted into gut incorrectly
• 90% diagnosed by 1 yo

Question 13

BIG symptom of malrotation

Answer 13

Bile vomiting - bright green (due to twisting being just after duodenum - so bile is not broken down)

Question 14

What is a sign of an infant with abdo pain?

Answer 14

Leg drawing (up to stomach)

Question 15

How do you diagonose volvulus and malrotation?

Answer 15

Contrast AXR

Intestines may be anchored in wrong position - not where you imagine them to be

Question 16

What is the name of malrotation surgery?

Answer 16

Ladd’s procedure (with appendectomy) - severage of the Ladd’s bands which can hold gut in incorrect position

Question 17

What is intussusecption? Where does it most commonly take place and what is its complication?

Answer 17

• When one segment of the intestine “telescopes” inside each other
• Ileo-caceal junction
• Obstruction

Question 18

Symptoms of intussusception?

Answer 18

-Blood and mucus stool
-Vomiting and diarrhoea
-Lethargy
- Abdo mass
(symptoms of obstruction)

Question 19

Gold standard testing for intussusception?

Answer 19

Air or barium enema - corrects case 90% of time

Question 20

If air/barium enema doesn’t cure intussception how would you cure?

Answer 20

Surgical release

Question 21

What type of atresia is a cause of jaundice in babies?

Answer 21

Biliary atresia

Question 22

What is gastroschisis?

Answer 22

Protrusion of the abdo contents through a defect (hole) in the anterior abdo wall (lateral to the umbilicus)

Question 23

What should bile vomiting be thought to be unless proven otherwise?

Answer 23

Malrotation

Question 24

“redcurrent jelly stool”

Answer 24

Intussception

Question 25

How does intussception appear on US?

Answer 25

Doughnut appearance