Paeds: Acute abdo pain Flashcards
Dx surgical
- Intussusception or other I.O.
- Peritonitis
- Trauma
- Meckel’s Diverticulum
- Acute Appendicitis
- Malrotation
- Inguinal hernia
Pancreatitis
Dx MEdical
- Gynaecological in pubertal females
- Sickle cell disease
- Non-specific abdo pain
- Mesenterc adenitis
- Hepatitis
- Constipation
- Toxin e.g. lead
- IBD
- Henoch-Schonlein purpura
- UTI, acute phylonephritis, hydronephrosis, renal calculus
- Gastroenteritis
DKA
Extra-abdominal
- URTI
- Lower lobe pneumonia – referred pain
- Hip and spine
Peritonitis in patients with ascites from nephritic syndrome
Intussusception: Definition
‘ Invagination of proximal bowel into a distal segment’
Intussusception: Epi
Commonest cause of Intestinal obstruction in infants after neonatal period.
Occurs between 2/12 and 2 yoa
Intussusception: Pathophysiology
Ileum passing o caecum/colon through ileo-caecal valve.
Intussusception: S&S
- Paroxysmal, severe colicky pain
- Draws up legs
- Pallor in episodes pain
- Abdo distension
- Sausage-shaped mass (often palpable)
Redcurrent jelly stool (blood-stained mucus)
Intussusception:
Diagnosis
AXR
Intussusception: Treatment
- I.V. volume expansion (often pooling of fluid in gut which may cause hypovolaemic shock)
- Rectal air insufflation
Operative reduction
Intussusception:
Complications
Shock
Meckels Diverticulum:
Definition
Ileal remnant of the vitellointestinal duct – Contains ectopic gastric mucosa or pancreatic tissue
Meckels Diverticulum:
S&S
Asymptomatic
Rectal bleeding
Meckels Diverticulum:
Other presentations
Intussussception
Diverticulutus
Volvulus around a band
Meckels Diverticulum:
Investigations
Technetium scan
Meckels Diverticulum:
Treatment
Surgical resection