General Emergencies

Question 1

What the radiology findings in pyloric stenosis

Answer 1

USS
Pyloric length >16mm and single wall thickness >3mm

Barium swallow is no sonographer available

Question 2

Paediatric intussusception

Answer 2

Peak incidence 6-9 months

Few children present with the typical triad
- abdo pain with drawing up of knees
- palpable abdo mass
- redcurrent jelly stool

Diagnosis
USS
AXR - SBO with lack of air in RLQ

Treatment
- resuscitation
- pneumatic reduction with air or CO2 (60-100mmHg)
- barium enema
- surgery for those that fail reduction or have signs of perforation or necrosis

Question 3

Surgical causes for vomiting in neonates

Answer 3

Malrotarion with Midgut volvulus
Pyloric stenosis
GI atresia
GORD

Medical: infection, metabolic, reflux