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
What can show double bubble sign other than duodenal atresia?
Volvulus
What will be dilated in volvulus
Stomach and duodenum
Dx volvulus
Upper GI contrast study
Rx volvulus
Laparotomy (?Ladds procedure if bowel healthy)
1w old baby with bilious vomit, looks toxic, tender abdomen
Volvulus
3 day old baby who didn’t pass meconium. Abdo distention, bilious vomiting.
Hirschprungs
Can babies with NEC continue to be fed?
Stop enteral feed for 10 days + broad spec Abx
A baby with VACTERL problems presents with choking and cyanotic spells after feeding
Oesophagel atresia
A three week old baby presents with jaundice which is shown to have increased conjugated fraction
Biliary atresia
A 5yo boy with central abdo pain and preceding fever and coryzal symptoms for 3 days
Mesenteric adenitis
