Gastroschisis

Question 1

Gastroschisis

Answer 1

exaomphalos (omphalocele) and gastroschisis are conditions where various organs can herniate in the abdominal wall.

in gastroschisis the herniated organs are not covered by the peritoneum

Question 2

Hirschsprung’s disease

Answer 2

failure of the ganglion cells to migrate to the hindgut. This leads to absence of co-ordinated bowel peristalsis and causes functional intestinal obstruction

first few days of life- abdominal distention, bile stained vomiting, failure to pass mconium

associated with trisomy 21

Question 3

meconium ileus

Answer 3

associated with CF
intraluminal obstruction in the terminal ileum
the lack of pancreatic enzymes causes thick and viscous meconium which results in bowel obstruction

Question 4

midgut volvus

Answer 4

intestinal obstruction at the duodenal level. infarction of the entire midgut

midgut malrotation is typically asymptomatic - can be detected with contrast meal

sx: bile stained vomit, circulatory collapse, abdominal tenderness
mx: immediate laparotomy to untwist the Volvos

Question 5

omphalocele / exomphalos

Answer 5

organs herniate through the abdominal wall but covered by the peritoneal sac.

baby’s abdominal cavity content are found outside the abnormal cavity and are covered by the amnion.

associated with anomalies- trisomy 13, 18, 21, turner’s syndrome, cardiac defects

Question 6

necrotising entercolitis

Answer 6

affected formula fed preterm infants most commonly in first few weeks of life

acute inflammation that affects different parts of the bowel (terminal ileum, ascending colon) can causes mucous injury and necrosis, which can lead to perforation.

symptoms- diarrhoea, haematochezia, vomiting, abdominal wall erythema./rash, abdominal distension and pain. lethargy, shock, CVS collapse, apnoea

IX: Xray shows dilated oedematous loops of bowel, intramural and portal venous gas.

Mx: bowel rest, discontinue oral feeding. IV abs, laparotomy to remove necrotic bowel.

Question 7

HUS

Answer 7

haemolytic uraemia syndrome
triad: acute renal failure, haemolytic anaemia, thrombocytopenia.

Ecoli
profuse diarrhoea, not bloody to begin with but turns blood on day 2-3. fever, lethargy, acute renal failure, anuria, seizures. hypertensive, oedema, pallor