Pediatric GI dis [3] Flashcards
Meckel diverticulum
Rule of 2:
affects 2% of population
symp at age 2
occurs 2 cm from ileocecal jxn (distal sm int)
This is an abnormal remnant of vitelline (omphalomesenteric) duct
- cnxn btwn yolk sac and intestine
- OUTPOUCHING OF THE INTESTINE but doesnt attach to the abdominal wall
Omphalocele
associated with advanced maternal age
Failure of intestine to return to abdomen following physiologic herniation at 6-10 weeks of dev.
(comes out of amniotic sac while liver enlarges)
Gastroschisis
paraumbilical abdominal wall defect (rectus m, not umbil) → no amniotic covering and no associated malformations
Which type of intestinal atresia is most common, and what is it assoc. with?
atresia: orifice/passage abnormally closed/absent
Duodenal atresia most common. 40% have Down syndrome.
Patho and presentation of intestinal atresia
possible vascular ischemic etiology
present: polyhydraminos, obstructive symptoms (bilious vomiting)
Hirschsprung disease
what
who
test/presentation
defect of Enteric nervous system (ENS) development resulting in ABSENCE OF GANGLION CELLS
4M:1F
Failure to pass meconium/poor stooling → MEGACOLON
(normal development of ENS begins in mediastiunum, but in Hirsh, it is unable to make it to distal colon)
Neonatal necrotizing enterocolitis
presentation
tx
Premies
Feeding intolerance
abdominal distention
bloody stools
bowel rest, antibiotics, surgical resection
Reflux vs Allergic esophagitis
Incompetent GE sphincter/hiatal hernia -
pH probe negative -
Histo: MILD intraepithelial eosinophilic infiltrate -
Predominantly distal and proximal esophageal involvement -
Tx: dietary mod + steroids -
Incompetent GE sphincter/hiatal hernia - reflux
pH probe negative - allergic
Histo: MILD intraepithelial eosinophilic infiltrate - reflux
Predominantly distal and proximal esophageal involvement -allergic (reflux is distal only)
Tx: dietary mod + steroids - allergic (reflux is acid block)
