GIped Flashcards
most common type of esophageal atresia
Type A(87%; EA and distal TEF)
frothing and bubbling at the mouth and nose; cough; cyanosis; respiratory distress; feeding exacerbates symptoms
TEF
Dx of TEF
inability to pass an NGT or OGT in the NB is suggestive
Management of TEF
maintain patent airway; prone position; esophageal suctioning; surgical ligation of TEF and primary end-to-end anastomosis of the esophagus
most common esophageal disorder in children of all ages
GERD
major mechanism in GERD allowing reflux to occur
transient LES relaxation
main stimulus for transient LES relaxation
gastric distension (straining; coughing; large volume or hyperosmolar agents)
Dx of GERD
Barium study of esophagus and upper GIT; esophageal pH monitoring; endoscopy; Radionuclide scintigraphy with Tc
Management of GERD
conservative therapy; lifetstyle modification
management for intractable GERD
fundoplication
physiologic strictures in the esophagus
cricoid cartilage; tracheal bifurcation; EG junction
type of necrosis caused by liquid alkali
liquefaction necrosis
type necrosis caused by acidic agents
coagulative necrosis
management of caustic ingestion
upper endoscopy; dilution by water/milk; surgical resection
intrinsic causes of intestinal obstruction
atresia; stenosis; meconium ileus; aganglionic megacolon
extrinsin causes of intestinal obstruction
malrotation; constricting bands; intra-abdominal hernias; duplications
classic symptoms of intestinal obstruction
nausea/vomiting; abdominal distention; obstipation
most common cause of nonbilious vomiting
pyloric stenosis
firm; moveable; olive-shaped mass; visible gastric peristaltic wave after feeding
pyloric stenosis
bulge on the pyloric muscle into the antrum in barium study of pyloric stenosis
shoulder sign
streaks of barium in the narrowed channel in pyloric stenosis
double tract sign
diagnostic tests for pyloric stenosis
UTZ is confirmatory(pylorus>4mm or length >14mm; barium studies
Tx for pyloric stenosis
Ramstedt pyloromyotomy
twisting of a loop of intestine around its mesenteric attachment site (usually sigmoid and cecum)
volvulus
triad of volvulus
Sudden onset of severe epigastric pain; inability to pass a tube in the stomach; retching with emesis
bird’s beak sign; inverted U sign; coffee bean sign
volvulus
Tx of volvulus
derotation and decompression; laparoscopic derotation or laparatomy +/- bowel resection
