Paediatrics Gastro

Question 1

Surgical problems.

a) Bilious vomiting in infant
b) Redcurrant jelly stool
c) Projectile vomiting post-feeds
d) Abdominal distention, failure of passage of meconium within the first 48 hours of life and repeated vomiting

Answer 1

a) Volvulus/malrotation
b) Intussusception
c) Pyloric stenosis
d) Hirschsprung’s disease

Question 2

Failure to thrive.

a) Categorise causes and give examples
b) Investigations

Answer 2

a) - Inadequate intake: reflux, other causes of vomiting, neglect, neuromuscular issues (poor swallow, anatomical)
- Malabsorption: CF, coeliac, IBD, chronic diarrhoea
- High demand: heart failure, chronic lung disease, asthma, hyperthyroid, kidney failure

b) - Bloods: FBC, CRP, coeliac serology, TFTs
- Imaging: CXR, ECHO
- Special tests: CF sweat test
- Growth chart: height, weight and head circumference centiles

Question 3

Diarrhoea in children
a) Causes
b) Ix
c)

Answer 3

a) Behavioural constipation (causing overflow), gastroenteritis or systemic infection, malabsorption, surgical causes, food allergy/intolerance

b)

Question 4

Constipation in children.

a) Causes
b) Management

Answer 4

a)

b) - Conservative: increase fluids, increase fibre, toileting routine, behavioural management
- Drugs: 1st line: Movicol ; 2nd line: add stimulant if soft (eg Senna) or softener if hard (eg docusate)