Paediatric Abdo Surg Flashcards
4 common surg Abdo presentations
Malrotation Hypertrophic pyloric stenosis Mesenteric adenitis Testicular torsion Intussusception APPENDICITIS.
Most common cause of vomiting in children
Sepsis
Infection
Common infections in children causing vomiting and Abdo pain
Meningitis
UTI
Pneumonia
Osteomyelitis
2 most important things to know when seeing a patient surg wise
How old
Boy or girl
When malrotation?
Neonate
Neonatal period?
28 days corrected.
Infancy timeline
28days till 12 months
Classic presentation of malrotation?
Bilious vomiting green
Bile is usually yellow
Malrotation with volvulus, what Ix?
AXR
U/S
Contrast study
Contrast study of malrotation, when surgery?
C for conservative if around pancreas
S for surgery if
What else do you do in malrotation surgery before
Appendicectomy. Caecum ends up being in left upper quadrant
Pyloric stenosis Incidence?
1:300
Pyloric stenosis demographics
3-6 weeks
Projectile vomiting
Male
Yes FHx can be if mother had it.
Pyloric stenosis vomit looks?
Non-bilious.
Pyloric stenosis after vomit, baby wants?
Want to feed
As opposed to malrotation or sepsis
Metabolic disturbance in Pyloric stenosis?
Hypokalaemic
Metabolic alkalosis
Hypochlorimic
Urine in Pyloric stenosis?
Paradoxical acid urea
Trying to keep sodium At kidneys
When operate for Pyloric stenosis?
When metabolic imbalance settles
Pyloric stenosis on U/S see?
Lengthening of pyloris and thickening of wall
Interssusception
Demographics
Male
Age: 5-7 months Peak, 3mo-3years
Intussusception Abdo pain?
Colicky, squeezing from peristalsis
Typical Intussusception position of baby
Legs up And colicky
Intussusception examination findings
Mass: early sign
Red currant jelly poo
Intussusception reduction?
Gas reduction, between 80-120mmhg under fluoroscopy
Doesn’t work
Pathological way-point, Meckel’s
Why 5-7 months Intussusception peak?
- Foods intro
- Stopping breast milk
- Lymph nodes get enlarged from more antigen exposure
- rotavirus
Intussusception U/S see what?
Target Sign
Appendicitis need to rule out?
UTI - more common
Appendicitis Kid’s under 5 presentation different how?
Early presentation
Early perforation
Mesenteric adenitis is?
Inflammation of lymph nodes,
Viral illness
Higher temps: 39
Pain can be bilateral lower quadrant
Ages of 8-12
