disorders of umbilicus and abdo wall in children Flashcards
Sx of umbilical infections
omphalitis
- periumb. erethyma
- purulent drainage
- bact
risk factors for infections (3)
- home deliv.
- low birth weight’
- umbil. caths
3 treatments
- local - warms soaks and topical ABs
- ABs
- surgcal drainage and debridement - rare
def. umb. gangrene/nec. fasch
- spreading erethyma, bloody disharge, purpura
- first 2 weeks of life
- high mortality
treatment
- radical exision and debridment
def. umbilical granuloma
benign granulation tissue
- present after cord separation
presentation of umb. grauloma
- mass
- chronic drainage
- skin irritation
3 treatments for granuloma
- silver nitrate
- excision
- look out for intestial mucosa
*what’s in the cord
2 As
1 V
what does 2 arteries become and patent or obliterated
patent
- medial umbilical folds
what does umb vein become and patent or obliterated
patent
- ligamentum teres and falciform ligament
- to ductus venosus
what does urachus/allantois become and patent or obliterated
obliterated
- median umbilical ligatment
what does OMD/vitelline duct become and patent or obliterated
obliterated
- none
6 possible OMD remnants
- umbilical mucosal remnant (sinus/polyp)
- OMD cyst
- meckels (most common)
- fistula
- omphacoel band
- vitelline vessel remnant
effects of OMD remnants
hemmorage
- obst
- imflammation
- umbilical sxs
- neoplasm
def. vitelline A remnant effects
still attached and can wrap around bowel and cause obstruction
3 possible urachal remnants
- patent urachus
- urachal sinus
- urachal cyst
6 possible manifestations of urachal remnatns
- umb. drainage
- pain
- infection
- urine
- mass
- abscess
2 tests to diagnose urachal remnants
- US
2. VCUG
2 possible treatments
- drain abscess
2. exision with closure of abdo
def. ubilical hernia
peritoneum lined, skin covered defect
- common
MGMT of hernia**
- almost never incarcerated
- v. rare to need surg
- most close by 4yo
- if not then repair
