PED: Vomiting And Failure To Thrive

Question 1

Infantile Hypertrophic Pyloric Stenosis is what?

Answer 1

Pyloric narrowing, patient has non-bilious vomiting, constipation, dehydration signs, and failure to thrive

Question 2

IHPS physical exam?

Answer 2

Olive shaped mass, and signs of dehydration

Question 3

Imaging of IHPS?

Answer 3

XR, barium swallow, and ultrasound

Question 4

Gold standard imaging for IHPS?

Answer 4

Ultrasound.

Question 5

Pre op management for IHPS is what?

Answer 5

Fluid resuscitation, given that they vomit and such, surgery has to wait until serum electrolytes and acid-base abnormalities are normal.

Question 6

So what is the surgery for IHPS

Answer 6

Ramstedt’s Pyloromyotomy

Question 7

Most common cause of Duodenal obstruction?

Answer 7

Duodenal atresia

Question 8

Duodenal atresia has 3 types, which is most common, and explain it

Answer 8

Type 1, a “web” is basically blocking the duodenum

Question 9

Clinical features of Duodenal obstruction

Answer 9

Bilious vomiting and intolerance of feeding.

Question 10

Ultrasound characteristic sign of duodenal atresia?

Answer 10

Double-bubble.

Question 11

Duodenal atresia finding on X-ray and Uktrasound?

Answer 11

Double bubble

Question 12

Treatment of Duodenal atresia generally

Answer 12

Open surgery or laparoscopic correction

Question 13

Treatment of Type 2 duodenal atresia

Answer 13

Diamond-shaped duodenodudenostomy

Question 14

Clinical presentation of malformation if the acute midgut volvulus is incomplete

Answer 14

The patient is fine in between the attacks of vomiting

Question 15

Clinical presentation of malrotation if the acute midgut volvulus is complete

Answer 15

Abdominal tenderness, bloodstained stools, sick looking patient

Question 16

Malrotation imaging X-ray reveals what

Answer 16

Multiple obvious dilated loops

Question 17

Pre op management of Malrotation with obv a mid gut volvulus

Answer 17

Urgent resuscitation, antibiotic admin, and nasogastric decompression

Question 18

Operative management of Malrotation

Answer 18

Ladd’s procedure

Question 19

In brief, summarize Ladd’s Procedure

Answer 19

Untwist the volvulus, divide Ladd’s bands, and straighten the duodenum

Question 20

Which jejuno-ileal atresia type has a Christmas tree anomaly (apple peel)

Answer 20

3B

Question 21

Which Jejuno-ileal atresia type has multiple defected like a string of sausages and looks like type 1 and 3 combined

Answer 21

Type 4

Question 22

Ultrasound for Jejuno-ileal atresia detects?

Answer 22

Dilated bowel loops and Polyhydramnios

Question 23

X-ray for a jejuno-ileal atresia shows?

Answer 23

Multiple air fluid levels, and ofc dilated bowel loops

Question 24

What is Meconium Ileus

Answer 24

An ileal obstruction due to the presence of abnormally viscid meconium. Essentially meconium causes an obstruction

Question 25

Intussesception clinical signs

Answer 25

Sudden onset of severe abdominal pain, and Dance’s sign upon abdominal inspection

Question 26

X ray shows what for intussusception?

Answer 26

Sausage mass

Question 27

Contrast enema shows what for intusseception?

Answer 27

Cobra head sign

Question 28

Treatment for Intussusception?

Answer 28

Operative reduction via laparotomy