Peds Exam 3 Gastrointestinal System Outline Flashcards
Paroxysmal abdominal pain or cramping
Colic
S/S Colic
Cries Pulls legs up Red Faced Fist Clenched 3h@3x a week
Tx Colic
Anti-flatulent
Car babies, swings, colic carry
Feet to head
Move–>get air out
Passive transfer of gastric content s into esophagus;
Gastroesophageal Reflux (GERD)
GERD S/S
Passive regurgitation/ emesis immediately less common( poor wt gain, gagging)
Sx GERD
Nissen Fundoplication
Projectile, sour smelling vomit
Visible peristalsis
–>hungry, dehydrated, FTT
Pyloric Stenosis
Na loss> H2O
Hypotonic Dehydration
Isotonic Dehydration
Turgor; feel & mucous membranes
Poor
Dry
Isotonic Dehydration
Pulse, behavior
Rapid, irritable to lethargic
Hypotonic Dehydration Skin
Very poor turgor, clammy, mucous membranes slightly moist, pulse very rapid
Hypotonic Dehydration Pulse
Very Rapid
Behavior-Hypotonic Dehydration
Lethargic to coma
Convulsions
Hypertonic Dehydration Skin
Fair, thickened, doughy, parched
Hypertonic Dehydration Pulse
Moderately Rapid
HR Dehydration
Hypotonic>Hypertonic>Isotonic
Tx Pyloric Stenosis
Sx Pyloromyotomy (Fredet-Ramstedt procedure) Pre-op: rehydrate Post-Op:Clear liquids
Telescoping of 1 portion of the intestine into another, may ->ischemia
Intussusception
Most common cause of intestinal obstruction (3mo-5yr)
Intussusception
Sausage shaped mass in URQ
(Ileoc. Valve=most common site)
WAVES of pain
Intussusception
Dx pyloric stenosis
U/s
Barium swallow
Dx evaluation intussusception
Barium enema (May be enough to fix-hydrostatic reduction)
Tx intussusception
Hydrostatic reduction
Sx-manual reduction & resection of any non-viable intestine
Post op intussusception
Alert MD of normal stool- passage of stool=reduced intussusception
Most common congenital malformation of gi tract
Meckel diverticulum
(Fistula)
Tx=Sx removal
S/s Meckel Diverticulum
Abd pain
Bloody stools
May be anemic
Dx Meckel diverticulum
Radionucleotide scintigraphy (Meckel Scan)
Abdominal pain, bloody stools, and occasionally anemic
Signs and symptoms of meckel diverticulum
Remnant of omphalomesenteric duct that Connects yolk sac w/ primitive midgut during fetal life fails to obliterate -> fistula
Mickel diverticulum