Gastro Flashcards
Causes for a cystic abdo mass
Hydronephrosis MCDK Adrenal haemorrhage Hydrometocolpos Intestinal duplication Choledochal/ovarian/pancreatic/omental cysts
Causes of solid abdo neonatal mass
Hepatoblastoma
Neuroblastoma
Congen mesoblastic nephroma
Teratoma
Risk factors for NEC
IUGR (meta analysis 2005; absent or reversed EDF OR for NEC 2.13)
PDA - INDEPENDENT assn, not made worse by indomethacin
Formula feeding (incr by 6x)
Increased gut pH: H2 blocker NEC OR 1.71 (but grain of salt b/c dont know if they were Rx first sign of NEC)
Bacteria necessary (gram neg, E.coli, klebsiella, clostridia) - major determinants of necrosis
Antenatal ABs for preterm ROM or preterm labour: AUGMENTIN increases NEC RR4.72 (Cochrane 2010)
?evidence behind not delaying feeds in
Leaf study 2012; 54 units:
Protective for NEC?
Steroids antenatally
BF babes get lactobacillus and bifidobacteria
Reducing gut pH (not standard practice)
? How much SB can babies live with post resection (e.g. NEC resection)
> 25cm with IC valve
Survival reported with 11cm
40cm without IC valve, reported with 25cm
Outcome predicted by residual length, % off calories tolerated by 12w enteral feeds (CGA)
? Pres of ICV
?associations with omphalocoele
Trisomy 18
Beckwith-Weidemann
Imperforate anus
Meningomyelocele
Most common cause of lower GI obstruction in neonates?
Hirschsprungs
Incidence and definition of Hirschsprungs
1 in 5000 live births
Absence of ganglion cells in submucosal
And myenteric plexus. Male 4 to female 1 for short segment.
80% rectosigmoid, while bowel aganlionosis is rare at 5%
Other congenital defects associated with Hirschsprungs?
Smith lemli optiz Downs Goldberg-shprintzen Shah-waardenburg Cartilage hair hypoplasia Congenital hypoventilation syndrome (PHOX2B) UG and CVS abnorms Microcephaly Mental retardation Abnormal facies, autism, cleft, hydrocephalus, micrognathia Jouberts Neurofibromatosis
