GI conditions Flashcards
How does Coeliac’s often first present in babies
Bloating upon weaning
At what age range is projectile vomiting a sign of pyloric stenosis
2-8 weeks
What is vomiting after paroxysmal coughing a red flag for
Whooping cough
What are signs of intestinal obstruction in a child
- bile-stained vomit
- abdominal distension
Where does pain occur in mesenteric lymphadenitis
RIF
Causes of intestinal obstruction in children
- Pyloric stenosis
- Atresia (duodenal, other sites)
- Intussusception
- Malrotation
- Volvulus
- Duplication cysts
- Strangulated inguinal hernia
- Hirschprung’s
When do babies usually pass meconium
Within first 48h of delivery
Differentials of baby not passing meconium in normal time
- CF
- Hirschprung’s
Most common cause of intestinal obstruction in infants after neonatal period
Intussusception
Presentation of gastroenteritis in children
- sudden change to loose stools
- vomiting
Most common viral cause of gastroenteritis
Rotavirus
Most common bacterial cause of gastroenteritis
Campylobacter jejuni
Presentation of Coeliac’s in children
- Faltering growth
- Abdominal distention
- Buttock wasting
- Abnormal stools (may be foul smelling)
- General irritability
Other diseases that give children a higher risk of developing Coeliac’s
- T1DM
- Autoimmune thyroid disease
- Down’s syndrome
How is Coeliac’s diagnosed
- screening test for anti-tTF and EMA
- confirmed by small intestine biopsy
Presentation of gastro-oesophageal reflux in children
recurrent vomiting/ regurgitation but putting on weight
When does gastro-oesophageal reflux usually resolve spontaneously in babies.
Why this age?
12 months.
Due to:
- maturation of LOS
- upright posture
- more solids in diet
Risk factors for gastro-oesophageal reflux becoming GORD
- cerebral palsy
- preterm babies (esp those with bronchopulmonary dysplasia)
Investigations for GORD
- 24h oesophageal pH monitoring
- endoscopy (identify oesophagitis, exclude other causes of vomiting)
Management of uncomplicated reflux in kids
- Parental assurance
- Thickening agents
- Smaller, more frequent feeds
Risk factors for having pyloric stenosis
- More common in boys (particularly firstborn)
* May have family history
Common primary food allergies in infants
milk, egg, peanut
Common primary food allergies in older children
peanut, tree nut, fish, shellfish
Symptoms of appendicitis in children
- Anorexia
- Vomiting
- Abdominal pain, guarding, tenderness (central localizing to RIF)
- Fever
Why is there a higher risk of rapid perforation for appendicitis in kids
Omentum is less well developed, fails to surround appendix
Common age group in which intussusception occurs
3 months to 2 years
Characteristic stool type in intussusception
Redcurrent jelly stool with blood-stained mucus
Symptoms of intussusception
- Paroxysmal severe colicky pain + pallor
- Off-feeds
- Vomiting
- Abdominal distention, shock
Signs of intussusception
- Sausage-shaped mass palpable in abdomen
* Redcurrent jelly stool with blood-stained mucus
What is intussusception?
In which part of the bowel does it usually occur?
- Invagination of proximal bowel into distal segment
* Commonly ileum into caecum
Gold standard diagnostic stool for intussusception
USS
Common first presentation of T1DM
DKA
How is T1DM diagnosed in children
Random blood glucose >11 mmol/l
