Newborn Flashcards
1
Q
Newborn: surgical congenital abnormalities
A
- diaphramatic hernia: if lung hypoplasia is compatible w/ life -oomph ocean +
2
Q
when is surgery contrainticated
A
congenital anomalies incompatible w/ life or that cannot be corrected
3
Q
VACTERL
A
- Vertabral,
- Ano-rectal
- Cardiac
- Tracheo-oesphageal
- Radial, renal
- limb
4
Q
Signs of diaphhramatic hernia
A
- resp distress
- dextrocardia , heart sounds more prominent oon the right
- bowel sounds in the chest
- scaphoid abdomen
5
Q
Dx of diaphhramatic hernia
A
- Ante-natal: U/S
- Chest X-ray: deviated mediastanum, air filled bowel in hemi-thorax
*
6
Q
Mx of diaphramatic hernia
A
- Evaluate lung hypoplasia
- trail of life
- gastric decompression
- resp support
- constant obs for pneumothorax
- Surgery: after weaning off ventilator
- reduction of abdominal contents
- repair of defect (mabye patch)
- look for other abnormalities
7
Q
Exompholos classification
A
- minor: defect les than 4cm, only bowel
- major: defect > 4cm , bowel + liver
8
Q
Mx Exompholos?
A
- Decompress Stomach w/ NG tube
- Manage fluid/ keep warm
- Antibiotics
- Plastic bag
- Refer
- Primary repair
- large defct - non operative treatment w/ aseptic ointments and delayed repair
9
Q
Exomphalos + Macrogloassia?
A
- Think Beckwith - Wiedermann Syndrome
- look for + correct hypo glycemia
10
Q
What is Gastroschisis?
A
- bowel through defect _to the righ_t of umbilicus w/ no membrane
*
11
Q
Mx Exomphalos?
A
- Enclose viscera: plastic bag
- Surgery: primary closure
*
12
Q
Cx Neonatal Intestinal obstruction?
A
13
Q
Clinical presentation of intestinal obstruction?
A
- Bile stained/ persistant non- bile stined vomiting
- High obstruction
- antenatal: Polyhydramnios
- vomiting presominates
- Low
- Abdo distension
- Delayed passage of meconium
- Abdo distension
14
Q
Investigastions Intestinal Obstruction?
A
- Antenatal U/S: polyhydramnios, associated anomalies
- X-Ray:
- Barium enema: distal obstruction
*
15
Q
Mx Intestinal obstruction?
A
- Resus + Rehydrate
- NG tube +/- suction
- Refer
- Define type + level
- surgical correction
16
Q
Signs of Oesophageal Atresia
A
- Antenatal: Polyhydramnios
- persistant drooling
- reguge of feed immediatly
- cannot pass NG tube
- X-Ray curled up in pouch
17
Q
Mx of oesophageal atresia?
A
- Replouge NG Tube with constant aspiration
- 15 degree head up position (prevent reflux through fistula )
- gastrostomy for feeds
- Manage other cogentital abnormataties
- treat aspiration pneumonia
- surgical
- extrapleural thoractomy
- closure of traceo-oesophageal fistula
- repair of oesophagus: can be in stages
18
Q
% of oesophageal atresia w/ fistula
A
- >90 %
19
Q
Duodenal Atresia - signs ?
A
- vomiting soon after birth
- stomach aspirate > 20ml
20
Q
Dx Duodenal Atresia?
A
- Double bouble w/withoiut distal air
- fenestration
- stenosis
21
Q
Meconium ileus presentation?
A
- Abdo distension at birth w/ palpable bowel loops
- vomiting not significant early on - bile stained
- Abdo X-Tay: Ground glass abdomen w/ dilated loops
- barioum enema microcolon
- look for cystic fibrosis
22
Q
Meconium illieus Mx?
A
- Half-strength gastrograffin enema if no peritonitis / volvulus
- Surgery:
- laparotomy if enemasa ae unsuccesful
23
Q
Hirshsprungs presentation?
A
- Neonatal intestinal obstruction
- Bowel Dysfunction e.g intermittent constipation w/ feed refusal + vomiting
- Abdominal Distention
- Explosive decompression on rectal rexamination
24
Q
Dx Hirshsprungs?
A
- Barium Enema: trasitional zone - dilated proximal bowel transitioning to narrow a ganglionic bowel
- Biopsy: absent ganglia
25
Q
Mx of Hirshsprung’s?
A
- decompress bowel w/ washouts
- surgery:
- colostomy proximal to ganglionic owel
- 6-9 months later : pull through
- early neonatal presentation: pull through w/ot colostomy
26
Q
A
