Pediatric Surgery Flashcards
A NG tube passed on a newborn with feeding difficulty is shown to be coiling in the upper chest. This is likely?
Esophageal atresia
Prior to operating on a newborn with esophageal atresia, what should be done?
VACTER anomaly rule out
What is the most important factor in a patient with congenital diaphragmatic hernia?
Their immature hypoplastic lung. Allow 3-4 for maturation before surgery.
Explain the gross differences between gastrochisis and omphalocele.
Gastrochisis has a normal cord, the defect is to the right of the cord, no protective membrane
Omphalocele has the cord to the defect and a thin protective covering
How long does it take for the bowel to begin to function in a baby with gastrochisis?
1 month
What three congenital anomalies have bilious vomiting and a “double bubble” X-ray?
Duodenal atresia, annular pancreas, malrotation
Malrotation can be diagnosed via?
Double bubble plus normal gas pattern distally
Contrast enema
Intestinal atresia has this characteristic finding on X-ray?
Double bubble with multiple air bubbles distally
A newborn developed abdominal distention and a rapid drop in platelets following his first feed. He was transferred to the NICU and started on IV nutrition. Imaging should be looking for these findings, which indicate surgery is needed?
An infant with necrotizing enterocolitis needs surgery when they have pneumatosis, portal vein air, pneumoperitoneum
This disease is common in newborns with CF who have a “ground glass” appearing bowel? How is it diagnosed?
Meconium ileus
Gastrograffin enema
What are the common H&P findings in a baby with hypertrophic pyloric stenosis?
- firstborn boys
- nonbilious vomiting
- eager for food
- visible gastric peristalsis
- palpable “olive” mass
Patients with hypertrophic pyloric stenosis will need this electrolyte abnormality corrected before surgery?
Hypocholremic, hypokalemic metabolic alkalosis
How is the diagnosis of Hirschaprung disease made?
A child with chronic constipation. Full thickness biopsy of rectal mucosa is diagnostic
What will a child with intussusception look like?
Extreme abdominal pain one second and normal the next. Usually 6-12 months old. Current jelly stools.
How is intussusception treated in a child? Adult?
Child: barium enema
Adult: surgery
