Gastro Conditions Flashcards
Commonest cause acute abdomen in child
Appendicitis
Commonest age group appendicitis
> 5 (difficult to diagnose under 2y)
What is the natural progression of appendicitis
Obstructed by often faecolith. Vague central abdominal pain. 6-12h full thickness appendix involved. 24-36h appendix gangrenous and will perforate
Appendicitis presentation
Periumbilical pain –> RIF when peritoneal irritation
Anorexia
Reluctance to move
Mild fever
Vomiting
Guarding
Rebound tenderness
Rovsings sign
Any change in bowel habits
6w old baby non bilious projectile vomiting after feeds. Not gaining weight well.
Pyloric stenosis
Abdo signs in pyloric sten
Olive mass
Visible peristalsis
Pyloric stenosis Rx
Surgery
Pyloric stenosis investigations
test feed
blood gas (hypochlor, hypokal met acidosis)
USS
6m old with spasms of colic, drawing legs up. Distended abdo and later bilous vomit
Intusussception
When can’t you do air enema in intussusception and why? What instead?
If got to redcurrant jelly phase or <24h as risk perf, so do laparotomy
3m old child who vomits after feeds. Is being fed >200ml/kg milk a day and is otherwise well
Regurg secondary to overfeeding
Bilous vomit means the obstruction is ____ to the sphincter of oddi
Distal
Duodenal atresia xray sign
Double bubble
Duodenal vs jejunal atresia distinction?
Duodenal double bubble xray
Jejunal abdo distention as more distal
What predisposes a child to volvulus?
Malrotation