Lower GI Surgical

Question 1

what is a Meconium ?

Answer 1

newborn baby’s first stool

Question 2

what is Meckel’s Diverticulum?

Answer 2

diverticulum of 2 inches coming off the ileum and can contain gastric mucosa which can release HCl
caused by the persistance of the vitelline duct (which drains yolk sac)

Question 3

what is the rule of 2s?

Answer 3

rule for Meckel's DIverticulum
2% population
2 years old
2inches long and 2 feet from ileocaecal valve
2 times more common in Men

Question 4

what are the complications of Meckel’s Diverticulum?

Answer 4

Rectal bleeding- ulceration, perforation and haemorrhage
Diverticulitis (can cause appendicits like symptoms)
Obstruction

Question 5

symptoms of Meckel’s Diverticulum?

Answer 5

bright red rectal bleeding
tarry stool- melena like
tenderness in umbilical region

Question 6

what is atresia?

Answer 6

congenital absence or abnormal closure of a body cavity

Question 7

what are the main types of atresia?

Answer 7

oesophageal atresia (difficulty swallowing/breathing), Intestinal atresia (green vomit)
Biliary atresia (jaundice and itching)

Question 8

what is Meconium Ileus?

Answer 8

meconium stool that passes very slowly in newborns as it is very sticky
patients with this are very likely to have Cystic Fibrosis

Question 9

What is the difference between Omphalocele and Gastoschisis?

Answer 9

Omphalocele- abdominal contents in a peritoneal layer protude and herniate into umbilical cord
Gastroschisis- abdominal contents with no peritoneal layer protrude out of anterior abdominal wall lateral to umbilicus

Question 10

what is intestinal malrotation?

Answer 10

a congenital abnormality in the gi tract where the intestines are twisted in the gut incorrectly due to the intestines not being attached to the back wall correctly

Question 11

what is the most common age of presentation for Intestinal Malrotation?

Answer 11

1 y/o

Question 12

what is the investigation mainly used to diagnose Intestinal Malrotation +/- Volvulus?

Answer 12

Contrast Abdo X ray

Question 13

what are the common symptoms for Intestinal Malrotation +/- volvulus?

Answer 13

bile vomit (green vomit)
abdominal distension
Abdo pain- leg drawing in babies

Question 14

what are the main risk factors of a Volvulus?

Answer 14

Intestinal Malrotation, pregnancy, abdominal abnormalities, colonic enlargement

Question 15

what is a Volvulus?

Answer 15

it is when a loop of intestine is wrapped around its own mesentery and causes intestinal obstruction

Question 16

what is the treatment of Intestinal Malrotation +/- Volvulus?

Answer 16

Ladd’s procedure via open surgery or laporectomy (more common)
Appendectomy

Question 17

what is Intussusception?

Answer 17

when a segment of the intestine is telescoped inside another segment causing intestinal blockage

Question 18

where is Intussesception most common?

Answer 18

Ileocaecal Junction

Question 19

what is a common cause of Intussusception?

Answer 19

Meckels Diverticulum, the diverticulum can telescope inside the ileum

Question 20

what scans are used for Intussusception?

Answer 20

USS
CT or X-ray
with or without Barium Enema

Question 21

what treatments are used for INtussusception?

Answer 21

Barium Enema

Surgery

Question 22

what are the main risk factors for Intussusception?

Answer 22

polyps
tumours
IBD
scar tissue