Pediatric Surgery Flashcards
Foregut
lungs, esophagus, stomach, pancreas, liver, gallbladder, bile duct, duodenum proximal to ampulla
Midgut
duodenum distal to ampulla, small bowel, large bowel to distal 1/3 of transverse colon
Hindgut
distal 1/3 of transverse colon to anal canal
Midgut
rotates 270 degrees counterclockwise normally
low birth weight
< 2,500 g
premature
< 37 weeks
Immunity at birth
IgA from mom’s milk; IgM synthesized in child
1 cause of childhood death
trauma; tachycardia best indicator of shock
GFR
children < 6 months old have 25% GFR capacity of adults - poor concentrating ability
Umbilical vessels
2 arteries and 1 vein
Caloric need
0-1 y –> 90-120 kcal/day
1-12 y –> 70-90 kcal/day
12-18 y –> 30-60 kcal/day
Pulmonary Sequestration
lung tissue has systemic arterial supply (aorta) and either systemic venous or pulmonary vein drainage; can be intralobar (more likely pulmonary venous drainage) or extralobar (more likely systemic venous drainage); neither communicates with tracheobronchial tree; most commonly presents with infection; can also have respiratory compromise or an abnormal CXR; tx: lobectomy
Congenital lobar overinflation (emphysema)
cartilage fails to develop in bronchus, leading to air trapping with expiration; vascular supply and other lobes are normal (except compressed by hyperinflated lobe); can develop hemodynamic instability (same mechanism as tension PTX) or respiratory compromise; LUL or RML most commonly affected; tx: lobectomy
Congenital cystic adenoid malformation
communicates with airway; alveolar structure is not well developed although lung tissue is present; respiratory compromise or recurrent infection; tx: lobectomy
Bronchogenic cyst
extrapulmonary cysts formed from bronchial tissue and cartilage wall; usually present with a mediastinal mass filled with milky liquid; can compress adjacent structures or become infected; tx: resect cyst
