Paeds GI Flashcards
Paeds GORD
- S&S
Paeds GORD S&S
- Vomiting after feeds
- Colicky
- Crying
Paeds GORD -2yo
- DDx
Paeds GORD DDx
- GORD
- 1-2 yo
- 10-20% - CMPI
- Cow’s milk protein intolerance
- Ig -> Skin test
- Non-Ig -> No test
Paeds GI
- Bowel frequency normal range
Normal Paeds BMs
BO 5/week
BO 2/3/day
Toddler’s Diarrhoea
- S&S
- Tx
Toddler’s Diarrhoea
- Symptoms
1. Pain
2. Loss of control - Tx
1. Laxatives
2. Manage infx/anatomy
Paeds GI
- Use of laxatives
Paeds laxatives
- Osmotic
- Movicol
- 1st line - Stimulant
- Docusate Na (DulcoEase, Norgalax)
- Senna (Senokot)
Paeds Celiac Disease
- Prevalence
- Associations
- DDx
Celiac disease
- 1% prevalence
- Association with
- Williams(-Beuren) syndrome (chr 7)
- 45, X0 (Turner’s)
- Trisomy 21 (Down) - Non-celiac Gluten Intolerance
- Non-inflammatory
- Non-carcinogenic
Paeds IBD
- Prevalence
- DDx
Idiopathic IBDs
- (6-12/100,000)
- Crohn’s
- UC
- Unclassified/Indeterminate
- Review later to establish
Recurrent Abdominal Pain Syndrome
- S&S
- Tx
Recurrent Abdo Pain Synd
- 4-5 episodes per week
- Very pale
- No D/C/B
Indirect hernia
- Pathophysiology
Indirect hernia
- Physiological outpouching of peritoneum
- Persistent processus vaginalis
- Bowel enters via deep inguinal ring
Spermatic cord
- Layers
Spermatic cord
- Gubernaculum pulls from urogenital ridge
- Tunica vaginalis (visceral and parietal)
- Parietal peritoneum
- Processus vaginalis obliterated - Internal spermatic fascia
- External oblique
- Deep inguinal ring - Cremasteric muscle
- Internal oblique - External spermatic fascia
- External oblique aponeurosis
- Superficial inguinal ring
Hydrocele
- Pathophysiology
- Presentation
- Management
Hydrocele
- Tunica vaginalis fluid
- processus vaginalis not obliterated - Presentation
- Can follow viral illness
- Larger at the end of the day - Conservative management
- Most close within first year
- Calpol during illness
- Surgery at 2-3 yo
Undescended testes
- Epidemiology
- Management
Undescended testes
- Epidemiology
- 1/20 term
- 1/3 premature
- From urogenital ridge - Surgery at 6mo
- EUA
- Laparoscopy
- Blood supply from cremaster and vas
Bell-clapper deformity
- Presentation
- Mx
Bell-clapper deformity
- Horizontal lying testes
- risk of torsion - Bilateral surgery
Torsion of Morgagni
- Anatomy
- Management
Torsion of Morgagni
- Anatomy
1. Hydatid of Morgagni (appendix testis)
2. Remnant of mullerian duct
Mx
1. Visible “blue dot” transillumination
- upper half of scrotum
2. Scrotal ultrasound
- Surgical removal of infarcted hydatid
Umbilical hernia
- Mx
Umbilical hernia
- Self-limiting
- Surgery after 2/3 years
Malrotation/volvulus
- Presentation
- Management
Malrotation/volvulus
- Day 2
- Bilious vomiting - Emergency laparotomy
Pyloric stenosis
1. Presentation
2. Management
3. Post-op
Pyloric stenosis
- Projectile vomiting
- Alkalosis
- Low KCl - Surgery
- Post-op CO2
- Respiratory compensation for alkalosis
- Low respiratory drive after GA
Gastroschisis vs Omphalocele
Gastroschisis vs Omphalocele
- Sac
- No sac in Gastroschisis
- Sac in Omphalocele - Outcomes
- Genetic associations in omphalocele
- Heat loss in gastroschisis
Omphalocele
- Prognosis
- Associations
- Management
Omphalocele
- Prognosis
1. More than 50% of fetuses will die - Associations
1. Pentalogy of Cantrell - CHD
2. Beckwith-Wiedemann syndrome - Better prognosis
- Management
1. Cover
2. NG decompression
3. Surgery - Elective if membranous sac is intact
HUS
- Cause
- Triad
- Mx
Haemolytic uraemic syndrome
- Cause
1. Diarrhoea - Shiga toxin EC
- Shigella
- Strep. p
2. Complement abnormalities
3. 2º - Drugs
- Cancer
- Triad
1. MAHA
2. Thrombocytopenia
3. AKI (50% dialysis)
+diarrhoea
+<5yo - Mx
1. Hydration
2. Avoidance - ABx
- Antimotility
- NSAIDs
2. RBC transfusion
