Pediatric Surgical Abdomen Flashcards
Clinical triad of Necrotizing Enterocolitis (NEC)
1) abdominal distention
2) bloody stools
3) pneumoatosis intestionalis (intramural bowel gas) *** pathognomonic
age range for presentation of hypertrophic pyloric stenosis
1-18 weeks, average is 3 weeks
Presentation of hypertrophic pyloric stenosis
- nonbilious vomiting after which INFANT IS STILL HUNGRY
- dehydration and poor weight gain
- RUQ “olive”
Meckel’s diverticulum diagnosis
a meckel’s scan, technetium 99m scan
Meckel’s diverticulum:
- presentation in children
- presentation in adults
- children: painless bleeding due to heterotopic gastric tissue
- adults: obstruction
what is the “rule of 2s” for Meckel’s diverticulum?
2% of population harbor it
2x more common in males
within 2 feet of ileocecal valve
What is the classic triad of intussusception
1) vomiting
2) abdominal pain
3) currant jelly stool
How is the abdominal pain associated with intussusception described?
colicky, severe, intermittent
Treatment for intussusception
Barium, water soluble or air contrast enema
What is the imaging study of choice for appendicitis?
- age < 14 yrs or pregnant ==> US
- adults ==> CT without contrast
What labs should be acquired in suspected appendicitis?
Labs tend to be worthless. WBC + CRP are sensitive but very poor specificity
What is markle sign?
patient drops from standing on toes to heels with jarring landing, or jumps ==> pain
suggests peritoneal inflammation
What is obturator sign
RLQ pain with internal rotation of the flexed right thigh
indicated inflamed appendix is in pelvis irritating the obturator internus muscle
What is Psoas sign
RLQ pain on thigh extension while lying in left lateral decubitus position
Indicates inflammed appendix is retrocecal irritating iliopsoas muscle
What is Rovsing’s sign?
LLQ palpation => RLQ pain
