GI Flashcards
Focus after delivery for these two structural disorders is airway and sucking.
Cleft lip and cleft palate
CL can be repaired by 3 mos
CP can be repaired around 6 mos
Protrusion of part of the gut or bowel through the inguinal ring into the scrotal or labial area
Treatment: Outpatient Surgery
Inguinal hernia
Common in infants
Umbilical rings does not close at the end of the first trimester
Treatment: None unless persists after 5yrs
Umbilical hernia
Complete closure of the anal passage
Immediate surgical intervention
rectal atresia
Narrowing/constriction of the rectal passage
Can have ribbon-like stools
rectal stenosis
No rectal opening
Child may have a fistula going to the GU system
imperforate anus
Thickened muscle (pylorus) causing a blockage causing projectile vomiting and olive shaped mass.
Pyloric stenosis
How is pyloric stenosis treated?
rehydration, surgery, & early feeds after surgery
D/C home is typically within 24 hrs
What is it?
Telescoping of a portion of the intestine, commonly at the ileocecal valve
How is it diagnosed?
Barium or Air Enema and imaging
How is it treated?
Enema or surgery if not corrected
Intussusception
Intussusception manifestations
jelly stools, sausage shaped mass, intermittent colicky cry, & fever
Abnormal rotation of the intestine around the superior mesenteric artery during fetal development
may lead to malrotation of the intestine. Life threatening if twisting of the intestine around itself, or volvulus, occurs.
S/sx of malrotation/volvulus
Intermittent bilious vomit/dehydration
Abdominal distention/pain
Lower GI bleeding
A palpable epigastric mass
Shock (if untreated)
Chronic inflammatory disease characterized by periods of exacerbations and remissions. Can affect any portion of the GI tract.
In children, acute or slow onsetabd pain, diarrhea, blood/mucous in stool, urgency/tenesmus, weight loss, RLQ cramping, fatigue
Crohn’s disease
An acute or chronic inflammation of the colon, which is characterized by recurring bloody diarrhea.
Symptoms include abd pain, bloody diarrhea, tenesmus, LLQ cramping, weight loss.
Ulcerative colitis
How is Crohn’s disease and Ulcerative colitis diagnosed? Treated?
By EGD and w/ surgery
Diet for Crohn’s
High fat, high carb, low residue, smaller/frequent meals, supplements
Diet for UC
High in protein, high carb, normal fat, decreased roughage, supplements
Inflammation of the appendix (end of cecum)
appendicitis
A positive Rovsing’s sign is indicative of acute appendicitis, characterized by inflammation, infection, or swelling of the appendix. What is Rovsing’s sign?
refers to pain felt in the right lower abdomen upon palpation
What manifestation would indicate the appendix is perforated?
sudden decrease in abdominal pain
Clinical manifestations of appendicitis
-Umbilical pain –> RLQ
-Vomiting
-Fever
-Perforation
Increased frequency and fluid content of the stools with or without associated symptoms.
Important to assess the presence of other signs and symptoms such as vomiting, fever, and pain.
diarrhea
Explosive, watery, pale, & odor
rotavirus
Green and watery stool
E. coli
Stool +blood
Salmonella
Delay or difficulty passing stool for 2 or more weeks
Constipation
Clinical manifestations of constipation
Hardened stool
Straining
Rectal Pain
Encopresis
Withholding behaviors
Return of gastric contents from the stomach through the lower esophageal sphincter back up into the esophagus
Functional reflux
Causes infrequent, episodic nonbilious, undigested formula
GER
Pathological reflux (choking, apnea, frequent OM/URIs, poor weight gain)
Common in premature infants and those with neurological issues
GERD
No intervention/tests needed for GER & GERD if weight gain is adequate
True or False
True
Invervention for GER & GERD
May consider thickened formula or breast milk
Need cross-cut nipple!
May need lactose-free formula
Smaller frequent feedings
Feed slowly
Do not vigorously play after feeding
Feed in upright position
30° for after feeds
A syndrome in which infants or young children fail to eat enough food to be adequately nourished and achieve age-appropriate weight gain as a result of: Inadequate caloric intake, Inadequate caloric absorption, & Excessive caloric expenditures.
Organic vs inorganic etiology
Treatment based on cause
Failure to thrive
The absence of ganglion cells results in lack of motility in the affected portion of the bowel. AKA aganglionic megacolon.
Hirschprung’s disease
Clinical manifestations of Hirschprung’s disease
Failure to pass meconium
Chronic constipation
Abdominal obstruction
Explosive BMs
Vomiting
Older children: foul smelling, ribbon-like stools
Decreased mucosal surface area. Usually from surgical resection of small bowel (due to NEC, volvulus, Crohn’s)
Short bowel syndrome
Treatment for short bowel syndrome
-Administration and monitoring of TPN
-Enteral feeding
-Emotional and developmental needs
Idiopathic, progressive, inflammatory process (postnatal or fetal) that causes an absence of some or all major intrahepatic and extrahepatic biliary ducts resulting in fibrosis and obstruction
Biliary atresia
Clinical manifestations of biliary atresia
Jaundice
Urine is dark-stains the infant’s diaper
Enlarged liver and spleen
Itchy
Sx of Cannabinoid Hyperemesis Syndrome (CHS)
nausea, stomach pain, tendency to take hot baths and showers for relief, difficulty eating/keeping food down, weight loss, severe vomiting and or diarrhea sometimes lasting days/weeks
