Gastrointestinal 2 Flashcards
Hirschsprung Disease
congenital absence of ganglion cells in wall segment of rectum + colon
>stops peristalsis
>inadequate motility
>caus obstruction in intestines
Hirschsprung Disease is assoc w…
- congenital heart defects
- down syndrome
- urinary tract anomalies
Hirschsprung Disease
manifestations
- ab distention
- bilious vomiting
- failure to pass meconium w/in first 24-48 hr after birth
- foul smelling diarrhea w blood
- severe chronic constipation
Hirschsprung Disease
diagnosis
rectal biopsy for ganglion cells
Hirschsprung Disease
treatment
- remove aganglionic portion
- colostomy
Congenital Diaphragmatic Hernia
abdominal contents protrude into thoracic cavity thru diaphragm
Congenital Diaphragmatic Hernia, ab contents are pushed against…
LUNGS
>20-35% mortality rate
> barrel-shaped chest
>sunken abdomen
Congenital Diaphragmatic Hernia
best position for infants
head + thorax higher than abdomen
>to facilitate downward mvmt of ab organs
Umbilical Hernia
weak or imperfectly closed umbilical ring
Umbilical Hernia
pushed thru when…
- coughing
- crying
- straining
Umbilical Hernia
reduced when…
pushing bowel back thru fibrous ring
-sometimes spontaneous improvement
Umbilical Hernia requires surgery if…
strangulation occurs or defects lasts 4-5 years
Appendicitis
inflammation by obstruction of appendiceal lumen
ruptured appendix + peritonitis is causes by…
edema continues>
>vasc supply is compromised
>bacteria invades
main sign of appendicitis
ab pain in RLQ or mcburney point
most common cause of emergency surgery in kids
appendicitis
sign of perforated appendix
sudden relief of pain
Appendicitis
nursing mgmt
start IV
draw labs
imaging
symptom relief
Appendicitis
labs
elevated WBC
elevated neutrophils
Appendicitis
imagine
appendix U/S
CT w contrast
Necrotizing Enterocolitis
inflammatory disease caused by ischemia or hypoxemia
>>produce vasc compromise of bowel mucosa + necrotic patches
>>interferes w digestion
Necrotizing Enterocolitis
mortality rate
5-24%
Necrotizing Enterocolitis is most common in..
premature infants
Necrotizing Enterocolitis is caused by…
>intestinal ischemia
>bacterial/viral infection
>immature GI mucosa
Necrotizing Enterocolitis
symptoms occur….
2nd week of life
Necrotizing Enterocolitis
manifestations
- incr gastric residual
- vomiting
- irritability
- ab distention
- blood diarrhea
if Necrotizing Enterocolitis is untreated…
progress to sepsis
Necrotizing Enterocolitis requires prompt treatment
- bowel rest
- gastric decompression
- abx therapy
Meckel’s Diverticulum
outpouching of ileum near the ileocecal alve
>poush contains gastric contents causes ulceration
Meckel’s Diverticulum
etiology
- appear by 2 y.o.
- most common GI malformation
Meckel’s Diverticulum
manifestation
- ulceration
- bowel obstruction
- perforation
- peritonitis
Meckel’s Diverticulum
diagnosis
- bleeding diverticulum
- occult blood stool test
Meckel’s Diverticulum
treatment
surgical removal of diverticulum + involved bowel
2 types of Inflammatory Bowel Disease
1 Crohn disease
2 Ulceritive Colitis
Crohn disease
targets which portion
randomly throughout GI tract
(like mouth + anus)
Crohn disease
manifestation
enteric fistulas bw loops of bowels + nearby organs
Crohn disease
diagnosis
radiologic + biopsy exams
Ulcerative colitis
targets which portion
entire length of bowel
(large intestine + rectal mucosa)
Ulcerative colitis
manifestations
- ESR
- CRP
- hypo-albuminemia
Risk of cancer is greater in _____ and slightly increased in _____
Crohn;
Ulcerative Colitis
Risk of cancer is greater in _____ and slightly increased in _____
Crohn;
Ulcerative Colitis
Gastroenteritis
inflammation of stomach + intestines
Crohn disease puts children at risk for…
dehydration
hypovolemic shock
T/F bowel patterns vary widely
TRUE
Constipation
ineffective rectal filling or ineffective rectal emptying
Constipation
therapy
- incr fluids
- bowel training
- incr high fiber
Constipation cycle
>child dislikes feelingof passing stools> holds it> stool hardens> makes it harder> more painful to pass
Crohn vs Ulcerative Colitis
1 Anal or perineal lesions
2 anorexia
3 diarrhea
4 growth retardation
5 pain
6 rectal bleeding
7 weight loss
