Pediatric GI

Question 0

Gastric Leiomyoma

Answer 0

MC benign gastric tumor

Question 1

Meckel’s Diverticulum

Answer 1

Pouch on the wall of lower intestine present at birth. (Congenital). Pouch may have stomach or panc tissue. Non compressible. Blood in stool.

Question 2

Mucocele

Answer 2

Dilated appendix filled with mucous.

Question 3

Crohn’s disease

Answer 3

Regional enteritis. Peristalsis absent or sluggish.

Question 4

Digestive tract / Alimentary tract

Answer 4

Mouth, pharynx, esophagus, stomach, small intestine, large intestine.

Question 5

Accessory glands

Answer 5

Salivary glands, liver, pancreas

Secrete digestive juice into digestive system

Question 6

GI hormones

Answer 6

Gastrin (via stomach)

Cholecystokinin (via fat in intestines, contracts GB)

Secretin: (via sm bowel to release bicarbonate to dec acid)

Question 7

Keyboard sign

Answer 7

Small bowel

Question 8

Gut signature

Answer 8

5 gut layers. Max diam 3 mm when distended, 5 mm when not.

Question 9

Duplication cyst

Answer 9

Walled off gut during embryologic development.

Question 10

Gastric Bezoar

Answer 10

Masses of congealed ingested foreign materials such as hair, veggie matter, inorganic matter. (Sand)

Question 11

Gastric Cancer

Answer 11

Not dx by US, older males, 1/2 in pylorus

Target, pseudokidney sign

Adenocarcinoma MC

Question 12

Appendicitis

Answer 12

Younger
Assoc with obstruction of appendicial lumen leading to inflammation

MC cause of childhood ab pain. 4-15 yrs. >200,000 cases/yr in US.

Fever, periumbilical pain, inc wbc, nausea, vomit due to pain, point tenderness RLQ

Noncompressible, inc color flow “ring of fire”, “thyroid in the belly sign”, hypo thick wall, periappendicieal fluid collection, appendicolith. Diam > 6mm, wall thick > 2mm

Tx: laparoscopy (small incision) or laparotomy (large)

Mc Burney’s sign. Pain when pressure release RLQ

Normal appendix sausage shape diam < 6mm and no Doppler flow.

Bacterial infection leads to gangrene and perforation

Appendix > 6mm or an appendicolith is highly suggestive of appendicitis

Question 13

Mc Burney’s Point

Answer 13

1/3 from ASIS to umbilicus is location of appendix

Question 14

Hypertrophic Pyloric Stenosis

Answer 14

Narrowing of the pylorus

Pylorus = channel between stomach and duodenum. It becomes thick due to contractility defect.

Projectile vomiting in neonates, palp olive shape mass

1st born males, white, maternal family hx, o & b blood.

Usually 2-6wks (17 mm, muscle thickness >3.5 mm, AP diam >10 mm

X-ray shows string sign.

Tx: pyloromyotomy, Ramsteadt

Question 15

Intussusception

Answer 15

Telescoping of bowel

Prox loop (intussuceptum) into distal loop (intussuscipiens)

90% ileocolic, males

6mn-2yrs, colicky ab pain, abd distention, vomit, abd mass, rectal bleed

Dark red jelly stool

Question 16

Diverticulitis

Answer 16

LLQ pain, fever, leukocytosis

Thickened bowel, abscess in LLQ highly suggests diverticulitis

Question 17

Congenital duodenal obstruction

Answer 17

Double bubble sign

Fluid filled duodenum and stomach separated by pylorus

Question 18

Mesenteric ischemia

Answer 18

Dec artery supply to intestinal system

Question 19

Rugae

Answer 19

Folds within mucosal layer of stomach

Question 20

Haustra

Answer 20

Folds within large intestine

Question 21

Layers of GI tract

Answer 21

5 layers

Serosa
Muscularis
Subserosa
Intramural
Mucosa