Paeds Flashcards
1
Q
Wilms
A
Findings
- Mass in the _ kidney
- Encases the kidney- claw sign
- Capsular rupture with subcapsular collection
- Separate from the adrenal gland
- No calcifications
- Doesn’t cross the midline
- Renal vein invasion- extends to the IVC
- Para-aortic lymphadenopathy
- No pulmonary metastasis
- Fat stranding around adrenal
- Left arch with abberant right subclavian
- No ascites
- No liver metastasis.
- No pneumoperitonum, pleural effusion or pericardial effusion
Diagnosis
- Wilms with subcapsular rupture, renal vein thrombosis and associated nodes.
Differential
- None
- Not neuroblastoma- no calcification, does not elevate aorta, does not encase vessels, crosses the midline, extends into the chest
Management
- Surgical referral
2
Q
Bronchogenic cyst
A
CXR
- Hyperlucent lung
- Over expanded left lung displacing the mediastinum to the right ( displaced azygo-oesdophageal line in the posterior mediastinum)
- No radio-opaque foreign body
CHEST CT
- Low density cyst
- Measures
- Posterior pericarinal mass( bridges superior, middle, posterior mediastinum)
- mass compresses and diplaces trachea
- Obstructs left main bronchus
Other
- No vascular abnormality (ring or sling)
- No vertebral abnormality
- Dilated air filled oesophagus + distended stomach
Differential diagnosis
- Neur-enteric cyst
- Oesophageal duplication cyst
3
Q
Long cases
A
PAEDS CT chest
- No vascular sling or abnormality
- No vertebral abnormality
*
4
Q
double aortic arch
A
Swallow
There is a posterior and anterior indentation of the mid oesophagus.
Contrast flows into the stomach.
There is no reflux of contrast.
No secondary or tertiary contractions.
CT
There is double aortic arch.
The right arch is dominant.
The right sub-clavian and the right common carotid arise of the right arch.
The left common carotid and left sub-clavian arise off the left arch.
Likely diagnosis
Double aortic arch.
Further investigation
- Specialist review
- Echocardiogram- for other cardiac abnormalities.
