Paediatric Surgery Flashcards
DDx paediatric abdominal pain?
Appendicitis Mesenteric adenitis Pneomonia Impaction Volvulus Intusseption Ileus
Non-specific abdominal pain
Important Hx questions for paeds abdo pain?
SOCRATES
Vomiting
What does pain near the umbillicus indicate?
Less likely to be pathological
What is murphy’s triad?
APPENDICITIS
- Pain over macburneys point
- Vomiting
- Fever
How do you DDx between appendicitis and non-specific abdominal pain?
Is it painful when moving?
Y = appendicitis
N = NSAP
Symptoms of mesenteric adenitis?
Non- septic
URTI
What causes a volvulus?
Developmental failure of small intestine during rotations
What is a volvulus?
Small intestine is on R hand side of abdomen pushing caecum up to R hypochondriac
Fibrous band covering upper duodenum obstructs caecum => volvulus (obstruction)
What are the symptoms of volvulus?
Billous vomit
Abdo pain
Inconsolable
Tachycardia then hypotension
SIRS
Investigation volvulus?
Urgent GI Contrast study (AxR with contrast)
What is treatment of volvulus?
Laparotomy Ladd procedure (removal of fibrous attachements)
What is intussecption?
Telescoping of one intestinal segment into another => obstruction
Symptoms of intussception?
BILLOUS vomiting
Short history of a viral illness
Bloody stool
What is the stool of intusseception described as?
Red current stool
Investigation intusseception?
USS
What is shown on USS in intusseception?
Target sign
Treatment intusseception?
Pneumostatic reduction
What should be done if pneumostatic reduction fails?
Laparotomy
What age is intusseception common?
6 - 12 months
What is gastroschisis?
Abdominal wall defect - causing abdominal contents to be outside of the abdominal cavity
Who is more affected by gastroschisis?
Males
Born to young mothers
What are 15% of gastroschisis associated with?
Other congenital abnormalities
Investigation for internal gastroschisis?
USS
Tx for gastroschisis?
Primary repair
Delayed repair w/ TPN
Same as omphalocele
Compare gastroschisis and omphalocele?
Different to an omphalocele as omphalocele is still in the peritoneal membrane
Omphalocele is UMBILLICAL defect not gut wall
