PATH - Embryo

Question 1

Gastroschisis

Answer 1

extrusion of abdominal contents through abdominal folds (typically right of
umbilicus); *not covered by peritoneum.

*guts spilled out

Question 2

Omphalocele

Answer 2

persistence of herniation of

abdominal contents into umbilical cord, *sealed by peritoneum

Question 3

Tracheoesophageal

anomalies

Answer 3

Esophageal atresia (EA) with distal tracheoesophageal fistula (TEF) is the most common (85%)

Polyhydramnios in utero

Neonates drool, choke, and vomit with *first feeding

TEF allows air to enter stomach (visible on CXR).

Clinical test: failure to pass nasogastric tube into stomach

In *pure EA the CXR shows *gasless abdomen.

Question 4

Duodenal atresia

Answer 4

Presents with *bilious vomiting and abdominal distension within first 1–2 days of life

failure to recanalize–>dilation of stomach and proximal duodenum (“double
bubble” on x-ray)

Associated with Down syndrome.

Question 5

Jejunal and ileal atresia

Answer 5

Presents with bilious vomiting and abdominal distension within first 1–2 days of life

disruption of mesenteric vessels–>ischemic necrosis–>segmental resorption (bowel discontinuity or “apple peel”).

Question 6

Hypertrophic pyloric stenosis

Answer 6

Most common cause of gastric outlet obstruction in infants

Palpable *“olive” mass in
epigastric region

*nonbilious projectile vomiting at ∼ 2–6 weeks old

associated with exposure to *macrolides

Results in hypokalemic hypochloremic
metabolic alkalosis

Question 7

Annular pancreas

Answer 7

ventral pancreatic bud abnormally encircles 2nd part of duodenum–>forms a
ring of pancreatic tissue

may cause duodenal narrowing

*nonbilious vomiting.

Question 8

Pancreas divisum

Answer 8

ventral and dorsal parts fail to fuse at 8 weeks

Common anomaly; mostly
asymptomatic

may cause chronic abdominal pain and/or pancreatitis