Pediatric Surgery 2

Question 0

6-8-week-old baby has persistent, increasing jaundice – suspected diagnosis? Rule out? (with?) work up? When surgery? Prognosis?

Answer 0

Biliary atresia

1. Sweat test to rule out cystic fibrosis
2. HIDA Scan after one week of phenobarbital (chloretic)

Surgery if nothing reaches duodenum after phenobarbital stimulation

#1/3 – long-lasting surgical derivation
#1/3 – needs a liver transplant after surviving for some time after surgical derivation
#1/3 – needs transplant immediately

Question 1

Patient begins non-bilious vomiting at age 3 weeks – suspected diagnosis? When surgery? Surgical options?

Answer 1

Hypertrophic pyloric stenosis

After rehydration/correction of hypochloremic hypokalemic metabolic alkalosis

Pyloromyotomy or balloon dilation

Question 2

Pediatric G.I. problems that present after first two months of life?

Answer 2

#Intussusception
#Meckel diverticulum

Question 3

Infant under one year presents with abdominal pain that causes them to squat – episodes last for about a minute. Suspected diagnosis? Diagnosed with? When surgery?

Answer 3

Intussusception; barium/air enema for diagnosis and therapy

Surgery if reduction is not achieved with enema, or if recurs

Question 4

Pediatric patient with lower G.I. bleed. Suspected diagnosis? Diagnosed with?

Answer 4

Meckel diverticulum; radioisotope scan for gastric mucosa in abdomen