GI Flashcards
hirschprung disease also known as
congenital (born with) aganglionic megacolon
why are ganglionic cells important
parasympathetic nervous system uses ganglionic cells to propel stool through colon
what is hirschprung disease
a portion of colon is aganglionic (without ganglionic cells)
what happens in hirschprung disease
a portion of the bowel lacks cells needed for motility; stool just stops; continues to build up; leads to mechanical blockage/obstruction
can you see liquid stool with hirschprung disease
sometimes
s/s of hirschprung disease
chronic constipation pencil thin/ribbon-like stools fecal odor on breath lg/firm abdomen rectal sphincter fails to relax ftt vomit/diarrhea (leakage) delayed passage of meconium
high incidence of hirschprung disease in this population
down syndrome
the diseased portion of the colon looks healthy and the non diseased portion looks unhealthy, why
mechanical obstruction occurs proximal (upstream) to diseased portion making healthy part appear enlarged
what procedure may be done to help kids with enlarged colon
temporary colostomy
hirschprung disease can lead to
enterocolitis - can lead to death
where do we see hirschprung disease most
recto-sigmoid area
dx for hirschprung disease
*rectal biopsy
manmatery (how tight is internal sphincter) - balloon for rectal pressures
barium enema
most common congenital malformation of GI tract
meckel diverticulum
onset (rules of 2) of meckel diverticulum
age 2 y.o. length is usually 2 inches in length occurs 2 feet from ileo-fecal valve 2 times more common in males 2% of population suffers 2 types of tissue (stomach and pancreatic)
what condition can happen from meckel diverticulum
perforation of diverticula
can lead to enterocolitis - can die
strangulation of the bowel - can lead to blockage
vulvus/twisting of the bowel
what is meckel diverticulum
congenital disorder of developing digestive system (yolk sac)
small pouches in the wall of intestine
meckel diverticulum s/s
painless frank (bright red) bleeding
dx procedure for meckel diverticulum
nuclear medicine - meckel scan
treatment for meckel diverticulum
surgery to repair
pyloric stenosis s/s
projectile vomiting
regurgitating
irritable
palpable olive shaped mass in rt upper quadrant
visible peristaltic waves from left to right
what is pyloric stenosis
constriction of pyloric sphincter with obstruction of gastric outlet
hypertrophy of pyloric sphincter - limits transition of food from stomach to duodenum
who is more affected with pyloric stenosis
males
down syndrome
cause of pyloric stenosis
idiopathic; may be inherited
when do symptoms present in pyloric stenosis
2-3 weeks old
***children with pyloric stenosis are at risk for
hypochalemic metabolic alcholosis
make them NPO
surgery for pyloric stenosis
pylomylootomy
intussusception manifestations
telescoping of a portion of an intestine into another
rotoshield vaccine was taken off of market due to
intussusception
intussusception most commonly occurs prior to this age
1 year of age
most common between 4-7 months
can occur at any point in life
children w/cystic fibrosis commonly have intussusception t or f
true
what part of the intestine is commonly involved in intussusception
ileocycl valve
cause of intussusception
unknown
dx for intussusception
barium enema - treats it as well
*characteristics of stools r/t intussusception
currant-jelly like stool (mucous and blood)
s/s of intussusception
acute pain colicky draw legs up vomiting feel sausage shaped mass in abdomen
celiac disease also referred to as
gluten induced enteropathy
what happens in celiac disease
individual cannot tolerate the intake of wheat
inability to detoxify/ingest glidden (protein) in wheat products
(wheat, oats, hops)
can use rice, soy, corn bases
what type of disorder is celiac disease
auto-immune disorder
celiac disease can lead to
malabsorption disorder - malnutrition
patho of celiac disease
intestinal inflammation - damage to villi-malabsorption-malnutrition
trt for celiac disease
gluten free diet - life long
usually resolves the issue
s/s of celiac disease
malnutrition
steattorrhea - fat in stool
abdominal distention
who is more prone to celiac disease
kids with diabetes
what type of disorder is esophageal atresia and tracheosophageal fistula
congenital disorder
malformation of trachea and esophagus
patho of esophageal atresia and tracheosophageal fistula
esophagus ends in blind pouch (atresia) - no connection between stomach and mouth
part of the trachea can attach itself to esophagus
positive indicator for esophageal atresia and tracheosophageal fistula
maternal polyhydraminos (too much amniotic fluid)
when suspecting esophageal atresia and tracheosophageal fistula look for big 3 C’s
coughing
choking
cyanosis
esophageal atresia and tracheosophageal fistula occurs
4-5th week gestation
premature/low birth weight infants
with esophageal atresia and tracheosophageal fistula what should we do
make child npo until dx/surgery to avoid aspiration
aspiration can lead to pneumonia
with esophageal atresia and tracheosophageal fistula look for other deficits, what are they
VACTERL VERTEBRAL ANAL CARDIOVASCULAR TRACHEAL ESOPHAGEAL RENAL LIMB DEFOMITIES
