Paediatric Gastrointestinal Disorders

Question 1

what sex is more likely to develop pyloric stenosis?

Answer 1

male

Question 2

how does pyloric stenosis present?

Answer 2

• projectile non-bile stained vomiting
• 4-6 weeks of life

Question 3

how is pyloric stenosis diagnosed?

Answer 3

test feed or USS

Question 4

what is the treatment for pyloric stenosis?

Answer 4

ramstedt pyloromyotomy (open or laparoscopic)

Question 5

how does mesenteric adenitis present?

Answer 5

central abdominal pain + URTI

Question 6

how is mesenteric adenitis managed?

Answer 6

conservatively

Question 7

what is intussuseption?

Answer 7

telescoping bowel proximal to or at the level of, ileocaecal valve

Question 8

at what age does intussuseption present?

Answer 8

6-9 months

Question 9

how does intussuseption present?

Answer 9

• colicky pain
• diarrhoea
• vomiting
• sausage-shaped mass
• red jelly stool

Question 10

what is the management for intussuseption?

Answer 10

reduction with air insufflation

Question 11

what conditions are associated with intestinal malrotation?

Answer 11

• exomphalos
• congenital diaphragmatic hernia
• intrinsic duodenal atresia

Question 12

what is a sign of a volvulus?

Answer 12

bile stained vomiting

Question 13

what is a volvulus?

Answer 13

loop of intestine twists around itself

Question 14

how is intestinal malrotation diagnosed?

Answer 14

• upper GI contrast study
• USS

Question 15

how is intestinal malrotation managed?

Answer 15

laparotomy

Question 16

how is volvulus managed?

Answer 16

ladd’s procedure

Question 17

what is hirschsprung’s disease?

Answer 17

absence of ganglion cells from myenteric and submucosal plexuses

Question 18

how is hirschsprung’s disease diagnosed?

Answer 18

rectal biopsy

Question 19

how does hirschsprung’s disease present?

Answer 19

• delayed passage of meconium
• abdominal distension

Question 20

how is hirschsprung’s disease managed?

Answer 20

• rectal washouts
• followed by anorectal pull through procedure

Question 21

what is oesophageal atresia associated with?

Answer 21

• tracheo-oesophageal fistula
• polyhydramnios

Question 22

how does oesophageal atresia present?

Answer 22

• choking
• cyanotic spells following aspiration

Question 23

what is VACTERL?

Answer 23

VACTERL stands for:
* vertebral defects
* anal atresia
* cardiac defects
* tracheo-esophageal fistula
* renal anomalies
* limb abnormalities

Question 24

how does meconium ileus present?

Answer 24

• delayed passage of meconium
• abdominal distension

Question 25

what condition is meconium ileus associated with?

Answer 25

cystic fibrosis

Question 26

what is seen on x-ray in meconium ileus?

Answer 26

• will not show a fluid level as the meconium is viscid

Question 27

what will PR contrast studies do in meconium ileus?

Answer 27

dislodge meconium plugs and be therapeutic

Question 28

how is meconium ileus managed?

Answer 28

• PR contrast + NG N-acetyl cysteine
• surgery

Question 29

how does biliary atresia present?

Answer 29

jaundice >14 days

Question 30

how is biliary atresia managed?

Answer 30

urgent kasai procedure

Question 31

what are the risk factors for necrotising enterocolitis?

Answer 31

• prematurity
• empirical antibiotics are given to infants beyond 5 days

Question 32

how does necrotising enterocolitis present?

Answer 32

• abdominal distension
• passage of bloody stools

Question 33

what is seen on x-ray in necrotising enterocolitis?

Answer 33

• pneumatosis intestinalis
• evidence of free air

Question 34

how is necrotising enterocolitis managed?

Answer 34

• total gut rest and TPN
• perforation –> laparotomy