Paediatric surgery Flashcards
Pyloric stenosis
- age of presentation
- presentation (3)
- investigations
- management
-6 wks
-thin/scrawny
stomach distended with gas due to attempted peristalsis
milky vomit
- Us- pylorus visible on US
- surgical: cut through the band of muscle surrounding the pylorus and spread it to widen
Intussusception
- age of presentation
- presentation (3)
- investigations
- management
-6 months
-vomiting green
firm abdo mass
redcurrant jelly stool
- US, see spiral like picture
- usually cured by air reduction so don’t need surgery
appendicitis
- age of presentation
- presentation (4)
- investigations
- management
-6-8 yrs
-vomiting + abdominal pain
pain over speed bumps indicates peritonitis
temperature
- US
- appendectomy, appendix inflamed with exudate
Malrotation
- what is it
- presentation (6)
- investigations
- management
-congenital anomaly of rotation of the midgut, the intestines are more likely to twist and cause a volvulus
-GREEN VOMIT \+ feeding intolerance poor growth anorexia constipation recurrent abdo pain
- Upper GI contrast with follow through
- Surgical- Ladd’s procedure
Testicular torsion
- presentation
- management
-acute swelling of the scrotum with sudden severe pain in one testis
abdo pain
nausea and vomiting
4 hrs from onset to necrosis
-manual reduction or orchidopexy
idiopathic scrotal oedema
- presentation
- management
-scrotum red & itchy but not sore
erytheyma extends to groin
tissue is waterlogged
-self resolving, give analgesia
physiological fibrosis of the penis
- presentation
- management
-parents worry but this is normal
-steroid cream and dab away pee
stretch in the bath
Balanitis xerotica obliterans
- presentation
- management
-foreskin white and scarred
may progress and cause urethral strictures
bad on presentation as in 9-11 yr olds
-circumcision
Paraphimosis
- what is it
- management
- retracted foreskin is unable to return from normal position due to oedema as a result of venous occlusion
- squeeze oedema out and then replace the foreskin
Hypospadius
- what is it
- management
- congenital abnormality of the renal tract, urethra not located at the head of the penis but further up
- surgery: restores function and appearance
Hydrocele
- what is it, why does it occur?
- management
-fluid sorrunding the testicle
during development testicle takes tongue of the peritoneum with it and if this doesn’t close off then the fluid can track down it
can trans-luminate (as can hernias)
-operate after the age of 2 as most self resolve
Hernia
- what is it
- management
-swelling with origin in the groin
can be sore if twisted and bowel can be compromised
-prompt repair
undescended testicle (cryptorchidism)
- presentation
- management
- why^^
- testicle impalpable in the scrotum and may be felt further up in the groin
- orchidopexy
-fertility issues
need the testicle to be examinable e.g. cancer
