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Final Notes > Paeds: Acute abdo pain > Flashcards

Paeds: Acute abdo pain Flashcards

1
Q

Dx surgical

A
  1. Intussusception or other I.O.
  2. Peritonitis
  3. Trauma
  4. Meckel’s Diverticulum
  5. Acute Appendicitis
  6. Malrotation
  7. Inguinal hernia
    Pancreatitis
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2
Q

Dx MEdical

A
  1. Gynaecological in pubertal females
  2. Sickle cell disease
  3. Non-specific abdo pain
  4. Mesenterc adenitis
  5. Hepatitis
  6. Constipation
  7. Toxin e.g. lead
  8. IBD
  9. Henoch-Schonlein purpura
  10. UTI, acute phylonephritis, hydronephrosis, renal calculus
  11. Gastroenteritis
    DKA
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3
Q

Extra-abdominal

A
  1. URTI
  2. Lower lobe pneumonia – referred pain
  3. Hip and spine
    Peritonitis in patients with ascites from nephritic syndrome
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4
Q

Intussusception: Definition

A

‘ Invagination of proximal bowel into a distal segment’

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5
Q

Intussusception: Epi

A

Commonest cause of Intestinal obstruction in infants after neonatal period.
Occurs between 2/12 and 2 yoa

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6
Q

Intussusception: Pathophysiology

A

Ileum passing o caecum/colon through ileo-caecal valve.

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7
Q

Intussusception: S&S

A
  • Paroxysmal, severe colicky pain
  • Draws up legs
  • Pallor in episodes pain
  • Abdo distension
  • Sausage-shaped mass (often palpable)
    Redcurrent jelly stool (blood-stained mucus)
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8
Q

Intussusception:

Diagnosis

A

AXR

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9
Q

Intussusception: Treatment

A
  • I.V. volume expansion (often pooling of fluid in gut which may cause hypovolaemic shock)
  • Rectal air insufflation
    Operative reduction
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10
Q

Intussusception:

Complications

A

Shock

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11
Q

Meckels Diverticulum:

Definition

A

Ileal remnant of the vitellointestinal duct – Contains ectopic gastric mucosa or pancreatic tissue

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12
Q

Meckels Diverticulum:

S&S

A

Asymptomatic

Rectal bleeding

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13
Q

Meckels Diverticulum:

Other presentations

A

Intussussception
Diverticulutus
Volvulus around a band

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14
Q

Meckels Diverticulum:

Investigations

A

Technetium scan

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15
Q

Meckels Diverticulum:

Treatment

A

Surgical resection

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16
Q

Acute Appendicitis: Definition

A

Commonest cause of abdo pain in children

17
Q

Acute Appendicitis: Symptoms

A
  • Anorexia
  • Vomiting
    Abdo pain – central and colicky, then localizing to R.I.F
18
Q

Acute Appendicitis: Signs

A
  • Flushed face with oral foector
  • Fever
  • Abdo pain aggravated by movement
  • Tenderness
    Guarding in r.i.f
19
Q

Acute Appendicitis: Note

A
  • Retrocaecal appendix: localised guarding may be absent

Pelvic appendix: few abdo signs

20
Q

Acute Appendicitis: Investigations

A
  • FBC

Laparoscopy

21
Q

Acute Appendicitis:

Treatment

A

Appendicectomy (if perforation give fluid resuscitation and i.v. prior to laparotomy)

22
Q

Acute Appendicitis:

Complications

A
  • Appendix mass
  • Abscess
    Perforation

Final Notes (196 decks)

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