Paediatrics Flashcards
Describe the different bowel gas patterns in neonates?
What are important differentials to consider for abnormal abdominal imaging?
What are the features of small left colon (aka meconium plug)?
What are the features of Hirschprung disease?
What are the features and associated anomalies of imperforate anus?
What is the treatment for meconium ileus?
Briefly describe ileal atresia and imaging findings.
Ileal atresia is a congenital abnormality with significant stenosis or complete absence of a portion of the ileum.
In 25% of cases associated with cystic fibrosis.
Pathology is due to an incident in utero that results in decreased perfusion and ischaemia.
What are the four types of Hirschsprung disease?
short segment disease: ~75% - rectal and distal sigmoid colonic involvement only
long segment: ~15%
- typically extends to splenic flexure / transverse colon
total colonic aganglionosis: ~8% (range 2-13%)
- also known as Zuezler-Wilson syndrome
- occasional extension of aganglionosis into the small bowel
ultrashort segment disease
- 3-4 cm of internal anal sphincter only
- controversial entity
If imaging shows neonatal colitis, consider?
Hirschsprung disease
describe the subtypes of oesophgeal atresia?
- proximal atresia with distal fistula: 85%
- isolated oesophageal atresia: 8-9%
- isolated fistula (H-type): 4-6%
- double fistula with intervening atresia: 1-2%
- proximal fistula with distal atresia: 1%
proximal atresia with distal fistula, descirbe the pathology
Associated conditions in patients with duodenal atresia?
- Down syndrome: ~30% of duodenal atresia cases may have Down syndrome while ~3% of Down syndrome cases may have duodenal atresia
- VACTERL association
- annular pancreas
- other intestinal atresias
jejunal atresia
ileal atresia
anal atresia
Describe jejunal atresia and the pathology?
Jejunal atresia is a congenital anomaly characterised by obliteration of the lumen of the jejunum. The site of the atresia can be anywhere from the ligament of Treitz to the jejunoileal junction.
The aetiology is thought to be from an ischaemic event in utero.
describe anal atresia subtypes and associations?
Anal atresia, or imperforate anus, refers to a spectrum of anorectal abnormalities ranging from a membranous separation to complete absence of the anus.
- other atresias
- oesophageal atresia 4
- VACTERL association
- caudal regression syndrome:
- Currarino triad: anorectal malformations with sacral anomalies and presacral mass lesion 6
- trisomy 21
subtypes
two broad categories:
high (supralevator)
low (infralevator), depending on the location of the atretic portion.
