Paediatric Surgery Flashcards
What are the 3 main symptoms that could warrant a surgical emergency in children?
Vomiting
Abdominal pain
Acute scrotum
What is the differential diagnosis of a 6-week-old child with milky projectile vomit and bulges on their abdomen? How is it diagnosed and managed?
Pyloric stenosis
US
Pyloromyotomy
What colour is bile-vomit?
Green (like Fairy-Liquid-green)
Bile-coloured vomit is a red flag. True/False?
True
A baby with bile-coloured vomit is what condition until proven otherwise? How is it diagnosed and managed?
Intestinal malrotation
Abdominal XR
Surgery
What is the differential diagnosis of a 6-month-old child with hard abdominal masses and “redcurrant jelly” faeces? How is it diagnosed?
Intussusception (bowel telescopes in on itself (small bowel into large bowel)
US
How is intussusception treated?
Blow air through bowel via anus
A 6-year-old boy complains of abdominal pain and “not liking the bumps en route to hospital”. He is reluctant to stand up. What is top of your differential list? How is it diagnosed and managed?
Peritonitis (can jump)
Appendicitis (can’t jump, fever)
US
Laparoscopic removal
List general symptoms of an acute scrotum
Redness Swelling Bruising Pain Abnormal position
List differentials of acute scrotum
Testicular torsion Epididymitis Idiopathic scrotal oedema BXO Hernia Undescended testis
What is a hydatid of Morgagni?
Vestigial Mullerian duct structure from development present on the top of the testis
1/3 have palpable blue dot discoloration on testis
What is balanitis xerotica obliterans? How is it managed?
Scarred foreskin with white hardened tissue which may prevent retraction
Circumcision
Hypospadias is the most common congenital defect of the penis. What is it?
Abnormally placed external urethral orifice on the urethral groove underside the shaft of the penis, causing pee to eject backwards
What is a hydrocele and what causes it?
Fluid accumulation around the testicle
Patent processus vaginalis
What test is done to detect undescended testis?
Soap test
Place soap between ASIS and pubic tubercle and slide thumb along line to palpate the testicle: if palpable surgery is performed, if not palpable laparoscopic procedure is performed to locate the testicle
What are the most common causes of GI obstruction in a child?
Congenital pyloric stenosis
Volvulus
Intusception
Malrotation
What is a red flag to be aware of in constipation?
Hirshsprugs - delay in passage of meconium for more than 24 hours post-birth
List features of tetralogy of fallot
Don't DROP baby vsD Rvh Overriding aorta Pulmonary stenosis
List signs of testicular torsion. How is it managed?
Red, sore, hard to walk, solitary bruise
4-6hr to treat
List signs of epididymitis. How is it managed?
Inflamed testicle
Red, sore
Antibiotics
What is idiopathic scrotal oedema? How is it managed?
Acute itchy testicle
Swollen, red
Waterlogged tissue
Antihistamines, analgesia but self-limiting
