Peds: GI Flashcards
What are some causes of constipation in kids?
intro of solid foods
toilet training
stressful environments (starting school)
cows milk
hischsprung’s
cystic fibrosis
hypothyroid
lead poisoning
When should a child pass their first stool by?
72 hrs
How is constipation diagnosed?
plain ab X-ray
What is the treatment of constipation?
infant- glycerin suppository, sorbitol-containing juices
children- miralax, dis-impaction, diet change
What is the definition of diarrhea?
passage of loose or watery stools 3 or more times/day
What is the #1 cause of diarrhea in developed countries?
rotavirus is common
norovirus is also common
What should be suspected if a child has bloody diarrhea?
slamonella
hemolytic uremic syndrome (E. coli)
intussusception
toxic megacolon
What is cleft lip?
Opening or split in the upper lip
What is cleft palate?
opening or split on the roof of the mouth
What is GERD?
present when passage of gastric contents into the esophagus causes toublesome symptoms or complications
What is GER?
normal physiologic process in infants & children
episodes do not cause symptoms
resolves by 18 months
What is respiratory disorder is commonly connected with GERD?
asthma
How is GERD diagnosed?
trial of acid suppression
barium swallow constrast
endoscopy
What is esophageal atresia & tracheoesophageal fistula?
congenital anomaly of the respiratory tract
incomplete separation of the trachea & esophagus
What are some S/S of esophageal atresia & tracheoesophageal fistula?
drooling
choking
respiratory distress
unable to feed
aspiration pneumonia
How is esophageal atresia & tracheoesophageal fistula diagnosed?
inability to pass NG tube into the stomach
upper GI series w/ endoscopy for direct visualization
What is pyloric stenosis?
hypertrophy of the musulature around the pyloric sphincter resulting in gastric outlet obstruction
What are some S/S of pyloric stenosis?
projectile vomiting after feedings
olive-shaped mass in RUQ
peristalstic wave just prior to vomiting
How is pyloric stenosis diagnosed?
ultrasound
barium swallow - string sign
What is Volvulus?
malrotation & abnormal rotation in utero which results in incomplete fixation of the small bowel
causes obstruction
What are some S/S of volvulus?
sudden onset of bilious vomiting (green vomit)
severe abdominal pain
if hypotensive, lethargic -> ischemia toxin has set in -> shock
HTN w/ tachycardia
How is volvulus diagnosed?
barium studies- bird-beak cut off & corkscrew of duodenum
ab plain films- double bubble sign
What is Hirchsprungs disease?
motor disorder of the gut
congenital absence of ganglion cells in the distal rectum & colon
What are some S/S of Hirchsprungs disease?
failure to pass meconium within 72 hrs of life
explosure epulsion of gas & stool after DRE (squirt sign)
signs of bowel obstruction
How is Hirchsprungs disease diagnosed?
rectal biopsy
What is the treatment for Hirchsprungs disease?
surgery
What is Meckel diverticulum?
incomplete obliteration of the vitalize duct, leading to a true diverticulum of the small intestine
What is the rule of 2’s with Meckel diversticulum?
occurs in 2% of population
male: female is 2:1
within 2 feet of ileocecal valve
can be 2 inches
usually presents before 2 yrs
What are some S/S of Meckel diverticulum?
painless GI bleeding (due to ulceration fo the small bowel)
recurrent intussusception
signs of appendicitis after and appendectomy
signs of a SBO
How is Meckel diverticulum diagnosed?
meckels scan (nuclear medicine)
What is an imperforate anus?
birth defects when the anus is malformed
opening of anus is missing or blocked
What are some S/S of an imperforate anus?
obvious defect at birth
low lesions- colon close to the skin (stenosis or blind pouch)
high lesions- may be fistula connection rectum to bladder or vagine
What is a hernia?
protrusion of an organ or tissue through an abnormal opening in the wall that normally contains in
What is a strangulated hernia?
incarcerated & blood supply is compromised causing ischemia
What population has the highest incidence of umbilical hernias?
When do most umbilical hernias close by?
African Americans
most will close by 4-5 yrs
What is a diaphragmatic hernia?
developmental defect in diaphragm allowing abdominal viscera to herniate into the chest, compromising normal lung development
What type of inguinal hernia is most common?
indirect
pass through inguinal canal
What is intussusception?
invagination of part of the intestine into self (most commonly ileocecal junction)
most common abdominal emergency in children < 2 yrs
What are some S/S of intussusception?
sudden onset of intermittent severe abdominal pain episodes
drawing legs/knees towards the abdomen
currant-jelly stools (mixture of blood & mucus)
How is intussusception diagnosed?
ultrasound- target sign or bulls eye
What is the treatment for intussusception?
barium or air-enema
surgery for unstable patients
What are some S/S of appendicitis?
RLQ pain
vomiting, fever
+ Rovsing sign
+ obturator sign
+ psoas sign
+ McBurneys point
pain with coughing/jumping
How is an appendicitis diagnosed?
CT scan
What is celiac disease?
immune-mediate inflammation of the small intestine caused by sensitivity to gluten & related proteins
How is celiac disease diagnosed?
serum celiac-antigen testing
