Congenital GI Conditions Flashcards
What maternal medication use may cause pyloric stenosis?
Erythromycin
What type of emesis will be present with pyloric stenosis?
NON-bilious, although projectile
List the main findings with pyloric stenosis
- Non-bilious vomiting after each feed
- Olive shaped mass in epigastric region
- Visible peristaltic waves
Olive shaped mass and visible peristaltic waves are seen with what condition?
Pyloric Stenosis
What imaging modality should be done with pyloric stenosis?
US
What metabolic derangement will be present with pyloric stenosis?
Metabolic Alkalosis
LOW K+ and Cl-
What is the treatment for pyloric stenosis?
NPO
Hydration/electrolyte correction
Pyloromyotomy
What is intussusception and where does it usually occur?
Portion of bowel telescopes into an adjacent portion
- often at ileocecal valve
What is the triad of symptoms with Intussusception?
- Episodic abdominal pain
- Vomiting
- Bloody “currant jelly” stool
What is the triad of symptoms with Intussusception?
- Episodic abdominal pain
- Vomiting
- Bloody “currant jelly” stool
What type of mass may be felt with Intussusception?
Sausage shaped in the RUQ with an empty RLQ
What will an US show with Intussusception?
Bullseye
What is the best diagnostic/treatment for Intussusception?
Air enema
Malrotation with volvulus involves what?
Bowel twists on itself causing an obstruction
What symptoms will be present with Malrotation/Volvulus?
Bilious emesis
Abdominal distention
Bloody stool
What symptoms will be present with Malrotation/Volvulus?
Bilious emesis
Abdominal distention
Bloody stool
What causes a Meckel Diverticulum?
Failure of the vitelline duct to obliterate which causes a true diverticulum
What type of ectopic tissue is the in the Meckel Diveritculum?
Gastric and Pancreatic tissues
What is the main sign of Meckel Diverticulum?
PainLESS blood in the stool
Painless blood in the stool is concerning for?
Meckel Diverticulum
Rule of 2’s with Meckel Diverticulum
2 types of tissue
2x more common in boys
2 years of life is common presentation
2 inches long
Within 2 feet of ileocecal valve
What test is diagnostic for Meckel Diverticulum? What does it detect?
Meckel Scintigraphy scan (tech 99m) detects gastric tissue
What causes Hirschsprung disease?
Lack of ganglion cells to migrate to the distal colon
When ganglion cells do not migrate to the distal colon, what occurs there?
Unopposed contraction, with no relaxation and no peristalsis
What is often the first sign of Hirschsprung Diisease?
Failure to pass meconium
With a rectal exam, what 2 findings are often seen with Hirschsprung Disease?
- NO stool in the rectal vault
- Expulsion of stool after rectal exam
If Hirschsprung disease is mild, how may it present in older kids?
Chronic constipation
What will be seen on XR with Hirschsprung Disease?
Distended proximal bowel with paucity (absent) of air in rectum
What will a Barium Enema show with Hirschsprung Disease?
Dilated proximal colon
Narrow distal colon
What is the most definitive test for Hirschsprung disease?
Rectal biopsy
What will a rectal biopsy show with Hirschsprung Disease?
Absent myenteric and submucosal plexuses
A portion of the bowel undergoes necrosis with Necrotizing Enterocolitis. What are 2 risk factors?
Premature birth
Formula feeders
In the first few days/weeks of life, what will present with Necrotizing Enterocolitis?
Feeding intolerance
Abdominal distention
Bloody stool
In the first few days/weeks of life, what will present with Necrotizing Enterocolitis?
Feeding intolerance
Abdominal distention
Bloody stool
What is diagnostic on XR for Necrotizing Enterocolitis?
Pneumatosis Intestinalis
= Air bubbles in the bowel wall
If you see air in the bowel wall, what should you suspect?
Necrotizing Enterocolitis
If Necrotizing Enterocolitis is more severe, what else can you see on XR?
Air under the diaphragm (perf.)
Air in portal venous system
What is the treatment for necrotizing enterocolitis?
NPO, IV antibiotics and surgery
