Paediatric Surgery Flashcards
How should undescended testes be managed?
If undescended at 3 months, refer to paeds surgery
What is the most common type of hernia in children?
Indirect inguinal hernia
How are inguinal hernias managed in children?
Surgical repair ASAP (due to high risk of strangulation)
How is malrotation voluvlus treated?
Emergency surgery - division of Ladd’s bands
Colicky abdominal pain, V&D, ‘Currant jelly stools’ suggests…
Intusussception
How is intusussception managed?
Usually treated with pneumatic decompression
Non-bilious projectile vomiting suggests…`
Pyloric stenosis
What is the investigation of choice for pyloric stenosis?
USS
Which ABG abnormality is usually found in pyloric stenosis?
Hypochloraemic Hypokalaemic Alkalosis
How is pyloric stenosis treated?
Pyloromyotomy
Bilious vomiting (within hours of birth) ‘Double bubble’ sign on x-ray suggests...
Duodenal atresia
How may Hirschsprung’s disease present in a neonate?
Failure to pass meconium within 48 hours
Bilious vomiting
Distended abdomen
How may Hirschsprung’s disease present in an older child?
Constipation since birth
Intermittent intestinal obstruction
How is a definitive diagnosis of Hirschsprung’s disease made?
Rectal biopsy
What are the key differences between Gastroschisis and Omphalocele?
Omphalocele - intestine covered by sac, not in Gastroschisis.
Omphalocele heavily associated with other abnormalities but Gastroschisis not so much.
Acute testicular pain with absent cremasteric reflex suggests…
Testicular torsion
Give key features of torsion of the hyatid/testicular appendage.
Pain at superior pole of testis
‘Blue dot’ sign
Cremasteric reflex present
How are undescended testes managed?
refer if not descended by 3 months
Orchidopexy by 9 months
Urethral opening on ventral aspect of penile shaft is called…
Hypospadias
How is hypospadias usually managed?
Usually repaired surgically around 6-12 months
What is phimosis?
Unable to retract the foreskin
Phimosis usually resolves by the age of…
3
What is paraphimosis?
Foreskin is retracted and cannot be replaced over the glans
Emergency - results in gangrene & auto-amputation
How is paraphimosis managed?
Emergency circumcision
