PED: Vomiting And Failure To Thrive Flashcards
Infantile Hypertrophic Pyloric Stenosis is what?
Pyloric narrowing, patient has non-bilious vomiting, constipation, dehydration signs, and failure to thrive
IHPS physical exam?
Olive shaped mass, and signs of dehydration
Imaging of IHPS?
XR, barium swallow, and ultrasound
Gold standard imaging for IHPS?
Ultrasound.
Pre op management for IHPS is what?
Fluid resuscitation, given that they vomit and such, surgery has to wait until serum electrolytes and acid-base abnormalities are normal.
So what is the surgery for IHPS
Ramstedt’s Pyloromyotomy
Most common cause of Duodenal obstruction?
Duodenal atresia
Duodenal atresia has 3 types, which is most common, and explain it
Type 1, a “web” is basically blocking the duodenum
Clinical features of Duodenal obstruction
Bilious vomiting and intolerance of feeding.
Ultrasound characteristic sign of duodenal atresia?
Double-bubble.
Duodenal atresia finding on X-ray and Uktrasound?
Double bubble
Treatment of Duodenal atresia generally
Open surgery or laparoscopic correction
Treatment of Type 2 duodenal atresia
Diamond-shaped duodenodudenostomy
Clinical presentation of malformation if the acute midgut volvulus is incomplete
The patient is fine in between the attacks of vomiting
Clinical presentation of malrotation if the acute midgut volvulus is complete
Abdominal tenderness, bloodstained stools, sick looking patient
Malrotation imaging X-ray reveals what
Multiple obvious dilated loops
Pre op management of Malrotation with obv a mid gut volvulus
Urgent resuscitation, antibiotic admin, and nasogastric decompression
Operative management of Malrotation
Ladd’s procedure
In brief, summarize Ladd’s Procedure
Untwist the volvulus, divide Ladd’s bands, and straighten the duodenum
Which jejuno-ileal atresia type has a Christmas tree anomaly (apple peel)
3B
Which Jejuno-ileal atresia type has multiple defected like a string of sausages and looks like type 1 and 3 combined
Type 4
Ultrasound for Jejuno-ileal atresia detects?
Dilated bowel loops and Polyhydramnios
X-ray for a jejuno-ileal atresia shows?
Multiple air fluid levels, and ofc dilated bowel loops
What is Meconium Ileus
An ileal obstruction due to the presence of abnormally viscid meconium. Essentially meconium causes an obstruction
Intussesception clinical signs
Sudden onset of severe abdominal pain, and Dance’s sign upon abdominal inspection
X ray shows what for intussusception?
Sausage mass
Contrast enema shows what for intusseception?
Cobra head sign
Treatment for Intussusception?
Operative reduction via laparotomy
Meconium ileus etiology?
Cystic Fibrosis
Electrolyte abnormality of Cystic fibrosis?
Hypochloremia
