Peadiatric surgery

Question 1

what three presentatiosn could warrant surgical intervention in children?

Answer 1

abdo pain

vomiting

acute scrotum

Question 2

• 6 week old baby feeding well but vomits milk straight back up
• two swellings on abdo- distended stomach

what is your diagnosis?

Answer 2

pyloric stenosis

Question 3

how would you investigate vomiting baby with distended stomach (possible pyloric stenosis)?

Answer 3

ultrasound

in babies without pyloris stenosis you shouldn’t be able to see muscle surroundign pyloris- if you can that indicates pathology

Question 4

what is the name of the procedure performed in pyloric stenosis?

Answer 4

pyloral myotomy- small cut in pyloric muscle so it can spring open

Question 5

if a child presents with a sore tummy what can you ask them to do to assess the pain?

Answer 5

ask them to jump- if they can’t jump then somthing wrong and refer

Question 6

vomiting bile will be what colour?

Answer 6

green

Question 7

if child is vomiting bile it is what until proven otherwise?

Answer 7

malrotation

Question 8

is malrotation an emergency?

Answer 8

yes- needs treated straght away if you wait until next morning could be too late for baby

Question 9

• 6 month old baby vomiting
• redcurrant jelly faeces
• episodes of crying and bringing up legs before going limp

diagnosis?

Answer 9

intussception

Question 10

describe intussception

Answer 10

bowel folding in on itself ‘telescoping’

swelling and obstructs

Question 11

how do you treat intussception?

Answer 11

blow air through the bowel via the anus

Question 12

how long do you have to treat torion of the testicles?

Answer 12

4-6hrs

Question 13

how does acute scrotum present?

Answer 13

redness

swollen

maybe bruised

diffficult to walk

Question 14

how does idiopathic scrotal oedema present?

Answer 14

red, swollen, itchy scrotum

redness in groin aswell

tissue can appear waterlogged

Question 15

a young boy presents with abdo pain and complains he doesnt like the bumps in the car journey, what is te diagnosis?

Answer 15

appendicitis

Question 16

what is the name of the congenital defect in which the openign of the urethra is on the underside of the penis?

Answer 16

hypospadius

Question 17

how do you test for undescended testicle?

Answer 17

soap test

take soap and put on the groin from ASIS to pubic tubercle then run thumb down inguinal canal and ou will fell it pop

if no pop need to do lap as can become malignant