PEDIATRIC Section 7: Luminal GI (SPECIAL TOPICS) Flashcards
Extra-abominal evisceration of neonatal bowel (sometimes stomach and liver) through a paraumbilical wall defect.
Gastroschisis
Herniated bowel loop through the ventral body wall NOT surrounded by a membrane
Gastroschisis
Herniated bowel loop through the ventral body wall Surrounded by a membrane (peritoneum)
Omphalocele
Herniated bowel loop through the ventral body wall + Normal Umbilicus - poistioned to the left of the defect (Defect is on the right)
Gastroschisis
Herniated bowel loop through the ventral body wall + Umbilicus contains hemiated bowel, and therefore is NOT normal
Omphalocele
Herniated bowel loop through the ventral body wall + Defect is on the right
Gastroschisis
Herniated bowel loop through the ventral body wall + Defect is midline
Omphalocele
Herniated bowel loop through the ventral body wall + with rare associated anomalies
Gastroschisis
Herniated bowel loop through the ventral body wall + High Association with Cardiac (50%) defects and Chromosomal Abnormalities
Omphalocele
What associated anomalies are common in omphalocele?
Trisomy 18
Turners
Klinefelters
Beckwith-Wiedemann,
Pentalogy of Cantral
Herniated bowel loop through the ventral body wall + good outcome
Gastroschisis
Herniated bowel loop through the ventral body wall + Intenstinal atresias
Gastroschesis
Herniated bowel loop through the ventral body wall + Cause: environmental
Gastroschesis
Herniated bowel loop through the ventral body wall + Genetic
Omphalocele
What is Pentalogy of Cantrell
What is an Enteric Duplication cyst?
developmental anomalies (failure to canalize)
DONT have comminication with GI lumen
Where are enteric duplication cysts commonly found?
Ileal region (40%)
Enteric Duplication cysts can cause what condition?
In Utero Bowel obstriuction/Perforation
Diagnosis?
Enteric Duplication Cyst
If you have a random cyst in the abdomen you need to ask yourself what?
“does this have gut signature? ”
WTF is gut signature?
It’s alternating bands of hyper and hypo echoic signal - supposedly representing different layers of bowel.
Cyst wih Gut Signature =
Enteric Duplication Cyst
Cyst without Gut signature
Omental Cyst
30% of the time, Enteric Duplication cysts are associated with what anomalies?
Vertebral anomalies
This is a cause of bowel obstruction in an older kid (20 year old) with cystic fibrosis (CF)
DIstal Intestinal Obstruction Syndrome
This is sometimes called the “meconium ileus equivalent, ” why?
DIstal Intestinal Obstruction Syndrome
because you end up with a distal obstruction (as the name implies) secondary to dried up thick stool.
DIstal Intestinal Obstruction Syndrome commonly involves what part of the colon?
Ileum/right colon
Self-limiting, usually viral inflammatory condition o f mesenteric lymph nodes. It is a classic clinical mimic of appendicitis.
Mesenteric Adenitis
cluster of large right lower quadrant Ivmph nodes.
Mesenteric Adenitis
immature bowel mucosa (from being premature or having a heart problem), and you get translocated bugs through this immature bowel.
It’s best thought o f as a combination o f ischemic and infective pathology.
Necrotising Enterocolitis (NEC)
Necrotising Enterocolitis (NEC)!
Who gets it?
- Premature Kids (90% within the first 10 days of life)
- Low Birth Weight Kids ( < 1500 grams)
- Cardiac Patients (sometimes occult) - they can be full term
- Kids who had perinatal asphyxia
- Hirschsprung Kids that go home and come back - they present around month 1.
most definitive finding of NEC
What do you look for?
Pneumatosis
Look for Portal Venous Gas Next
the region most affected by NEC
terminal ileum / right colon - Focal dilated bowel
Describe the small bowel in NEC
Featureless small bowel, with separation (suggesting edema).
