Paediatric surgery

Question 1

Rough weight equation

Answer 1

Weight(kg)= 2*(age+4)

Question 2

Rough blood volume equation

Answer 2

Blood vol (mls)= 80/kg

Question 3

Urine output equation

Answer 3

1ml/kg/hour

Question 4

What is the insensible fluid loss of a child?

Answer 4

This is the amount of fluid lost from the lungs, skin, repsiratory and GI tract in a day.

~20ml/kg/day

Question 5

What is the equation for the systolic pressure of a child?

Answer 5

Stystolic BP (mm hg) = 80 + (2*age)

Question 6

How do RR, HR and BP (systolic) change with age?

Answer 6

RR and HR decrease
Systolic BP increases

In under 1 year RR 30-40, HR 110-160, BP 70-90
In >10 year olds RR 15-20, HR 60-100, BP 100-120

Question 7

What is Gastroschisis and how is it treated?

Answer 7

This is an abdominal wall defect where all of the gut has come outside of the abdomen. No visceral covering

treat with delayed closure and TPN

90+ % survival.

Question 8

What is exomphalos? How is it treated?

Answer 8

This is an umbilical defect where the gut is outside the abdomen with a visceral covering.

Associated with other anomolies e.g. Cardiac, Chrosomal, Renal, Neurological

Managed:
Primary/delayed closure.

Has 25% post-natal mortality

Question 9

How can you distinguish between an umbilical hernia and a paraumbilical hernia?

Answer 9

Paraumbilical hernias tend to point to feet but umbilical hernias tend to point striaight up in air.

Question 10

What is intusscueption? How is it investigated and treated?

Answer 10

When one part of bowel slides inside other. Rarely seen outside the ages of 6-18 months.

Investigations:
USS abdomen- target sign seen

Treatment:
Penumostatic reduction/air enema- air pumped through endoscope to push inner part back out

or
Laparotomy