general surgery of childhood Flashcards
what are the the differential diagnosis of acute scrotum ?
testicular torsion
strangulated inguinal hernia
epididymo-orchitis
torsion of testicular appendages
what is the first line of management in an acute scrotum patient ?
history and exam
what is the presentation of strangulated inguinal hernia ?
reducible hernia
vomiting
what is the presentation of testicular torsion?
acute onset
testis is higher in position than normal
unilateral loss of cremasteric reflex
no relief of pain on elevation
what is the test of choice for definitive diagnosis of testicular torsion ?
ultrasound with doppler ( reduced vascularity )
what is the time period of surgical indication associated with suspected testicular torsion ?
surgical exploration within 6 hours
how to initiate cremasteric reflex ?
scratch the medial side of the upper thigh
what is the prognosis of torsion of testicular appendages ?
causes pain
but of no value
not an emergency
what are the DDx of acute abdomen ?
acute appendicitis intestinal obstruction ovarian torsion torsion ovarian cyst colitis - mesenteric lymph adenoids stones
what is the presentation of acute appendicitis ?
severe abdominal pain
guarding of the right iliac fossa
generalized then becomes localized to right illiac
what does the pain of acute appendicitis mimic ?
lower lobe pneumonia
what is the treatment for intussusception ?
air enema
what is a sausage shaped mass suggestive off on radiology ?
intussusception
along with bilous vomiting and bleeding per rectum
what is coffee bean sign on radiology suggested off ?
sigmoid volvulus
what is the initial management for any intestinal obstruction ?
drip and suck
how does hydrocele present ?
painless swelling of one or both testicles
trans illuminates
fluid drains back at night
what is the management for hydrocele ?
just observational
should resolve within a year
what is the most common complication of hydrocele ?
indirect inguinal hernia
what is hypospadias ?
opening of the urethra is not located at the tip of the penis
when should repair of hypospadias occur ?
between 6 months and 2 years
what is the contraindication to performing a circumcision ?
presence of hypospadias
curvature of the penis
when is surgery for UDT recommended ?
again at the age of 6 months
how should bleeding after circumcision be dealt with ?
compress
resuscitate
refer to a surgeon
what is the prognosis of an umbilical hernia ?
usually the defect closes at around 4-5 years of age
