GI Flashcards
what is trachea-oesophageal fistula and how do you diagnose
connection between oesophagus and trachea. usually closes in the 1st trimester. allows food to enter the oesophagus
an NG tube is fed down to see if it can reach stomach and surgery can fix it
symptom of TOF antenatally
polyhydramnios
absent stomach bubbles on antenatal US
symptom of TOF postnatally
oesophageal atresia- drooling and coughing during feeding
symptoms of pyloric stenosis
projectile vomit half hour after eating
constipation and dehydration
olivie-mass in abdo
how do you diagnose and manage pyloric stenosis
US and surgical removal of smooth circular muscle
what is gastroschisis
congenital malformation of the anterior abdominal wall lateral to umbilical cord
exposing the bowel out of the abdominal wall without covering sac
can lead to dehydration and protein loss
how do you diagnose gastroschisis
antenatally on 20 week anomaly scan
how do you manage gastroschisis
when baby is born cover abdomen in clear wrap and straight for surgery
what is exomphalos
abdominal contents is covered in amniotic fluid
what is duodenal astresia
duodenum has a dead end cut off and the stomach is unconnected to the rest of the bowel
it obstructs passage of food and secretions and resembles small bowel obstructions
symptoms of duodenal astresia
polyhydramnios in utero
bilious vomiting and abdominal distention
diagnosis of duodenal astresia
abdominal X-ray shows double bubble sign
management of duodenal astresia
NG tuve and IV fluids
surgical correction
what is meckels diverticulum
outpouching of the ileum and occurs due to failure of the vitelline duct
follows rule of 2s
seen in 2% of ppl
usually 2 inches long
with 2 feet of the ileocecal valve
twice as present in males
symptoms of meckels diverticulum
painless blood in stool, small bowel obstruction, similar to appendicitis
investigations and management of meckels diverticulum
CT abdomen and laparotomy
what is Hirschsprung disease
error in development of the nervous plexus which supply the distal segment of large bowel
Meaning no innervation of the smooth muscle so peristalsis can’t occur
symptoms of Hirschsprung disease
– Delayed passage of meconium (>48 hours after birth)
– Signs of bowel obstruction –> abdominal distension, bilious vomiting
– Poor growth
– Chronic constipation in childhood
diagnosis of Hirschsprung disease
rectal examination
suction rectal biopsy
management of Hirschsprung disease
bowel irrigation and surgery
treatment of constipation
osmotic laxative-movicol
stimulant laxative if not resolved after 2 weeks
investigations for cows milk allergy
IgE mediated condition
skin trick test
management of cows milk allergy
cut out cows milk and give mother replacement calcium
give eHF milk when breastfeeding stops
what is intussusception
proximal segment of bowel telescopes into the lumen of the adjacent bowel.
symptoms of intussusception
abdo pain, voimtiing, blood stained stools, sausage shaped mass in RUQ
diagnosis of intussusception
US
CT
management of intussusception
rectal air insufflation or surgery
what is biliary atresia
progressive fibrosis and obliteration of the biliary tree, which impedes the outflow of bile. Bile starts to build up and resemble cholestatic picture
symptoms of biliary atresia
mild juandice
pale stools, dark urine
normal birthweight
tests for biliary atresia
Blood test shows high ALP, ALT, and high levels of conjugated bilirubin
– Ultrasound shows biliary tract distension with a contracted or absent gallbladder
– ECRP –> fails to outline a normal biliary tree
management of biliary astrsia
1st line is Kasai procedure – This is a Hepatoportoenterostomy (loop of jejunum anastomosed to cut surface of porta hepatis)
– If unsuccessful, liver transplant maybe required
what is mesenteric adenines
right iliac fossa pain, older than 2 years, tests normal but with a previous infection
