Gastroenterology

Question 1

What is intussusception?

Answer 1

Invagination of bowel into itself
Narrowed lumen, thickened overall bowel size
Occurs in infants 6 months - 2 years
More common in boys

Question 2

What are the conditions commonly associated with intussusception?

Answer 2

Concurrent viral illness
Henoch-Schonlein purpura
Cystic fibrosis
Meckel’s diverticulum
Intestinal polyps

Question 3

What is the presentation of intussusception?

Answer 3

Sev, colickly abdo pain
Pale, lethargic unwell child
Redcurrant jelly stools
RUQ mass (sausage shaped)
Intestinal obstruction (abdo distention, absolute constipation, vomiting)
Recent URTI

Question 4

What is the management of intussusception?

Answer 4

Diagnosis = USS / contrast enema
Reduce intussusception with therapeutic enemas (contrast, air, water)
Surgical reduction (if enema failed)
Surgical resection in case of gangrenous / perf bowel

Question 5

What are the potential complications of intussusception?

Answer 5

Perforation
Gangrenous bowel
Intestinal obstruction
Death

Question 6

What is the management of Omphalocoele / Exomphalos?

Answer 6

Staged closure starting immediately with completion at 6-12 months (gradual repair prevents respiratory complications)
? C section indication to prevent sac rupture

Question 7

What is the management of gastroschisis?

Answer 7

Newborns to theatre as soon as possible after delivery (within 4 hours)
Vaginal delivery may be attempted