paediatric GI Flashcards
why do babies get GORD?
-babies have immature lower oesophageal sphincter
how does GORD present?
- regurgitation
- chronic hiccups
- presents in 1st 2 months of life and improves in first year
investigations for GORD?
- clinical diagnoses
- older kids= 24 hour ambulatory oesophageal pH monitoring
- Suspect oesophagitis= endoscopy
treatment for GORD?
- self resolves in 1 year
- avoid over feeding, feed in prone
- gaviscon immediately after feed
how does pyloric stenosis occur?
progressive hypertrophy of pyloric sphincter muscle which leads to gastric obstruction
how does pyloric stenosis present?
- projectile vomiting (roughly 30 mins after feed)
- child remains hungry and eager to feed
- weight loss
- dehydration + constipation
what investigations are done for pyloric stenosis?
examination- olive shaped mass in RUQ
USS- hypertrophic pyloric muscle (DIAGNOSTIC)
Blood gas- hypochloraemia, hypokalaemia + metabolic alkalosis
treatment for pyloric stenosis?
Ramstedt pyloromyotomy
what is intussusception?
- telescoping of small bowel leading to obstruction
- usually involving the ileocecal valve
- can cause bowel necrosis if left untreated
presentation of intussusception?
- child unwell/ floppy
- palpable ‘sausage’ mass
- red current jelly in stool
- vomit + episodic colicky abdo pain
investigations for intussusception?
USS- kidney bean or target/ bulls eye sign
treatment for intussusception?
conservative= air enema retraction
surgical= laparascopic surgery
what causes malrotation with volvulus?
- absent mesentery attachments
- allows organs to wrap around eachother (leading to volvulus)
presentation of malrotation with volvulus?
-green, bilious vomit is malrotation with volvulus until proven otherwise
investigations for malrotation with volvulus?
1st= Abdo Xray
2nd= upper GI contrast