Paediatric Surgery

Question 1

Pathophysiology of biliary atresia

Answer 1

The bile duct is either narrow or absent which causes cholestasis therefore there is an accumulation of conjugated bilirubin

Question 2

Biliary atresia presentation

Answer 2

Jaundice at birth - high conjugated bilirubin

Persistent jaundice - > 14 days in term babies or > 21 days in premature babies

Question 3

Management of biliary atresia

Answer 3

Surgery - Kasai portoenterostomy

Phototherapy - decrease bilirubin levels

Question 4

Causes of intestinal obstruction

Answer 4

Meconium ileus 
Hirschsprung’s disease 
Oesophageal atresia 
Duodenal atresia 
Intussusception 
Imperforate anus 
Malrotation with a volvulus 
Strangulated hernia

Question 5

Presentation of intestinal obstruction

Answer 5

Persistent vomiting - bilous
Abdominal pain and distention
Constipation
Tinkling or absent bowel sounds

Question 6

Investigations for intestinal obstruction

Answer 6

DRE
Abdominal Xray
Abdominal MRI
Abdominal USS - intussusception

Question 7

Managing intestinal obstruction

Answer 7

Medical emergency - A-E
Nill by mouth - NGT
IV fluids