Pediatric Surgery Lecture Powerpoint

Question 1

Anatomy of a pediatric airway vs adult

Answer 1

Child is funnel shaped narrowing at the bottom, adult is cylinder shaped

Question 2

Normal amount of blood donated in 1 unit

Answer 2

500mL

Question 3

Children are more prone to blood loss resulting in a dangerous situation because….

Answer 3

….they have much less volume to begin with (400ml in neonate compared to 355ml in the average coke can) therefore losing an amount of volume puts them at higher class of shock than an adult

Question 4

The most common disease in children

Answer 4

Trauma - high risk population for accidents

Question 5

Waddell’s triad and what does it often occur with?

Answer 5

• contralateral head injury
• splenic fracture
• left femur fracture

-often in children struck by a car where they go on the hood and then are thrown off onto the ground when the driver brakes

Question 6

Seatbelt sign

Answer 6

Bruising across the abdomen in children injured by a seatbelt, can see injuries to the small bowel, pancreas, colon, mesentary, and back ligament tearing

Question 7

The narrowest spot in the GI pathway is the…

Answer 7

…LES

Question 8

Strong acids tend to injure via ___ if ingested, strong alkaline agents tend to injure via ___

Answer 8

perforation of the stomach, liquefactive necrosis in the esophagus all the way down

Question 9

Most common surgical disease of the newborn

Answer 9

Necrotizing enterocolitis (NEC) - infection and death of bowel tissue most common in premature infants of unknown etiology

Question 10

Malrotation with volvulus definition

Answer 10

Surgically emergent procedure in children where the intestine becomes twisted and does not make turns as it should resulting in potential necrosis, may manifest as bilous vomiting

Question 11

Intestinal atresia definition

Answer 11

Missing unformed blocked intestine most common in the ileum, results in swelling of the proximal bowel and shrinking of the distal bowel resulting in bilous vomiting, abdominal distension and failure to pass meiconium, has 5 subtypes

Question 12

Pyloric stenosis definition, diagnosis, and treatment options (1)

Answer 12

Often presents with projectile NONbilous vomiting, can be visualized on ultrasound, treated with hydration and pylormyotomy

Question 13

Hydrocele vs inguinal herniation distinction in a newborn

Answer 13

hydrocele lacks an inguinal bulge vs the inguinal hernia has one typically

Question 14

Intusussception definition, diagnosis/treatment (same)

Answer 14

Often presents as colicky pain without relief by comfort and frequently passing currant jelly stools, contrast enema (or surgery if can’t be treated)

Question 15

Hirschprung’s disease definition

Answer 15

Absence of ganglion cells on distal bowel (must bipsy) that results in inability to dilate and inability to pass meconium, requires resection of aganglionic bowel

Question 16

Characteristic x ray finding of duodenal atresia

Answer 16

Double bubble finding

Question 17

A child with belly pain that progresses into fever and then vomiting and worsening is….

Answer 17

…..appendicitis until proven otherwise (peak age 9-11 years old)

Question 18

Appendicitis diagnostic studies (2)

Answer 18

• ultrasound

- CT

Question 19

What is the most common cancer in children?

Answer 19

Leukemia

Question 20

What is the most common extracranial tumor in pediatric patients?

Answer 20

Neuroblastoma - often grow on the adrenal gland

Question 21

2nd most common childhood abdominal malignancy

Answer 21

Wilms tumor

Question 22

Ovarian teratomas

Answer 22

Childhood or teenage tumors that can be malignant 5-10% of time often as a suprapubic mass, 1/3 cause acute abdominal pain due to torsion of ovary (you can see teeth sometimes on x ray or hair upon removal)

Question 23

Sacrococcygeal teratoma

Answer 23

Large exophytic soft tissue mass in the region of the sacral area that grows before birth and needs surgical excision, typically has good outcomes at preserving musculature and anal function