Foundational Neonatal Surgery Flashcards
what are the potential umbilical problems?
omphalophlebitis: vein
omphaloarteritis: arteries
patent urachus
when does the urachus normally seal?
after being disconnected from placenta
when should surgery be performed on a patent urachus?
if fails to close in 2-3 days
what is acquired patent urachus usually from?
secondary to infection of an associated structure
when does bladder rupture occur?
during parturition/dystocia
what diagnostics can you do for a bladder rupture?
serum chemistry profile
abdominal ultrasound
abdominocentesis
contrast radiograph
methylenblue instillation of of bladder colors the abdominal fluid if defect present
what serum chemistry changes are seen with a bladder rupture?
hyponatremia
hypochloremia
hyperkalemia
metabolic acidosis
peritoneal:serum creatinine >2
what is the most common complication of treatment for bladder rupture?
cardiac arrest during general anesthesia
what are the components of an umbilical hernia?
umbilical ring
umbilical sac
umbilical remnants
what is the most common type of hernia?
umbilical hernia
what is an umbilical abscess likee?
firm
not reducible
when can conservative treatment be used for an umbilical hernia?
less than 5 cm
less than 6 months of age
many close within a week
what is most commonly in an inguinal hernia?
small intestine +/- small colon
what is an indirect or true hernia for an inguinal hernia?
small intestine passes through vaginal ring into vaginal tunic
when does a indirect inguinal hernia usually resolve?
after first few weeks of life
why should you ultrasound a body wall hernia?
to assess content and size of hernia ring
is there strangulation of bowel
what are the risk factors for umbilical infections?
poor sanitation
failure of passive transfer
inappropriate care of umbilicus
important to follow the umbilical vein all the way up to the __________ and the arteries to the ___________
liver
bladder
how quickly should improvement be seen on ultrasound for umbilical infections?
within a week of treatment
surgery if does not improve
what should you do if septic joints are seen with an umbilical infection?
remove infected umbilicus surgically
when can an acquired patent urachus occur?
up to 14 days after birth
when should surgery be performed on an acquired patent urachus?
if not resolution with antimicrobials
what should you remove in umbilical surgery?
umbilicus
arteries
vein
urachus
when should you not proceed with treatment for a bladder rupture?
K+ >6 mEq/L
