Emergency Flashcards
Common PC in paeds
- Fever (UTI)
- Abdo pain
- Cough
- Breathing
- Seizures
- Rash
Atypical febrile seizures
> 3 febrile seizures
- Fever differentials
- Kawaski
- Meningococcal sepsis
Define Intussusception
the movement or ‘telescoping’ of one part of the bowel into another
Most common type of intussusception
ileocaecal 90%
Intussusception presentations
- Severe, colicky abdo pain (sudden onset Inconsolable crying, draw up their knees)
- RUQ ‘sausage’ shaped mass
- Redcurrant jelly stools (late preentation)
intussusception exam stem
- Viral URTI preceeding to intussusception
- Bowel bostruction feaetures: **Abdo distention, constipation, vomiting **
intussusception Ix/Dx
- Abdo USS
- AXR
- Contrast enema
intussusception Mx
Fluid resus if signs of shock/dehydration +/- NG tube if obstructed bowel
1. Theraputic enema: Contrast, water or air are pumped into the colon forcing the intussusception back into position
2. Surgical reduction
3. if bowel gangrene / perforation: Surgical resection
intussusception complications
- Bowel obstruction
- Gangrene bowel
- Peroforation
- Dehydration and shock
- Death
intussusception Risk factors
- 2-12 months
- Male
- Recent viral infection
intussusception USS distinctive feature
- Target/Doghnut sign
How do intussusception lead to dehydration and shock?
Fluid and bowel contents can collect within the intussusception
Risk of therapeutic enema Mx for intussusception
Bowel perforation
Intussusception Pathophysiology
The telescoping/invaginating of one bowel segment into another can lead to intestinal obstruction
Intussusception causes
Idiopathic
Meckel diverticulum (most common)
Polyps
Henoch-Schönlein purpura
Lymphoma and other tumors
Post-operative
Intussusception peak age prevalence
2-12 months of age
