Emergencies Flashcards
At 6 weeks what is the most common abdominal complaint?
Pyloric stenosis.
How does pyloric stenosis present?
Abdominal gas, windy child, poor growth, vomiting
How is pyloric stenosis fixed?
Surgical split of the pylorus.
What causes pyloric stenosis?
Hypertrophy of the pyloric muscle
How is pyloric stenosis diagnosed?
USS
At 6 months what is the most common abdominal complaint?
intussusception
What symptoms will intussusception present with?
Vomiting green
Firm mass on palpation
Melena in nappy
How is intussusception diagnosed?
US
What will the US show in intussusception?
swirly target lesion which is layers of bowel inside one another
How is intussusception solved?
Air reduction (air enema)
What is malrotation?
The superior mesentery is unstable and not fixed well to the peritoneum and can wrap around the bowel
How will malrotation present?
Vomiting green bile
Abdo pain
Eating little and often
Small faeces
What investigation is needed for a malrotation?
Upper GI contrast and follow through
What is the risk after a GI surgery?
Adhesions
What is the most common cause for scrotal pain?
Hyatid of Morgagni, an accessory testicle
How does this Hyatid of Morgagni cause pain?
If it undergoes torsion then it can cause necrosis, swell and be painful.
How can you tell if it is a Hyatid of Morgagni?
May feel like a bead on the scrotum
May look like a bruise
Have a high level of suspicion
What is the treatment for a hyatid of morgagni?
Surgical removal of the growth will fix the issue
What is idiopathic scrotal oedema?
Oedema of the dartos fascia, possibly by eosinophilia
How does idiopathic scrotal oedema present?
Erythema spreading perianally to the IF.
Scrotum will be swollen, feel waterlogged and possibly itchy.
How is idiopathic scrotal oedema cured?
Supportive treatment with reassurance that it will resolve in
What is banalitis xerotica obliterates?
Scarring of the foreskin which may cause the inability to retract it
What is the only treatment for BXO?
Circumcision
What is paraphimosis?
Foreskin which is stuck behind the glans and cannot be retracted
How is paraphimosis solved?
Manual manoeuvre where the foreskin is moved back into its anatomical position.
A dorsal slit is sometimes used to aid this.
What is a hypospadias?
Congenital abnormality of the urethral tract so the urethra is not on the glans
At what age can a hypospadias be fixed?
Over 3 months
What is a hydrocele?
Collection of fluid around the testicle
What causes a hydrocele?
Patent processus vaginalis. Occurs embryologically when testis is descending from peritoneum
What is the pattern of a hydrocele?
May be absent in the morning as the fluid drains out and present in the evening.
On examination, what is a hydrocele like?
Can get fingers above it and can feel fluid.
May be transilluminable.
Why must an undescended testicle be forcibly descended?
Higher cancer risk
Infertiity
If something goes wrong, you can’t find it!
Where might the undescended testicle lie?
At the deep ring, where the testicular vessels and vas deferens meet.
If on ABCDE, C is not adequate how can this be addressed?
20ml/kg of 0.9% saline
