pestana: pediatric Flashcards
esophageal atresia presentation
excessive salivation and choking spells after birth
most common type of esophageal atresia
blind pouch of upper esophagus
lower esophagus fistula to tracheobronchial tree
manage esophageal atresia
rule out other VACTER anomalies: anus, CXR, echo, US (renal)
surgical repair. gastrostomy to protect lungs
manage imperforate anus
if fistula present: delay repairing until further growth
if no fistula: make colostomy if high pouch or repair if low pouch
congenital diaphragmatic hernia always on right or left
left
manage congenital diaphragmatic hernia
wait 3-4 days for repair to allow lungs to mature
meanwhile: intubation, ventilation, sedation, NG suction
gastroschisis vs omaphalocele presentation
g: defect to the right of a nl cord, no protective membrane, angry bowel
o: cord goes to defect, protective membrane, nl bowel
manage gastroschisis and omaphalocele
large defects need siliastic “silo” to protect bowel, gradual over week squeezed into belly.
wont work for a month so need parenteral nutrition
extrosphy of the urinary bladder management
repair within first 1-2 days
extrosphy of the urinary presentation
abdominal wall defect over pubis
red bladder mucosa, wet shining with urine
malrotation diagnosed how
contrast enema or upper GI study
differential for green vomiting and a “double bubble”
duodenal atresia
annular pancreas
malrotation
intestinal atresia cause and effect
vascular accident in utero–> multiple air fluid levels of atresia areas
necrotizing enterocolitis presentation
premature infants
feeding intolerance, distention, low platelets (sepsis)
treat necrotizing enterocolitis
stop feeding
broad spec abx
IVF, IV nutrition
surgery if air present
