Surgery Flashcards
6 weeks old with projectile vomiting
pyloric stenosis
what causes the lumps on the abdomen in pyloric stenosis
normal peristalsis waves pushing against the pylorus
why do you get pyloric stenosis at 6 weeks
pylorus muscle thickens and causes a physical obstruction to the milk being taken in
what is the treatment for a pyloric stenosis
pyloromyotomy - cutting the muscle of the pylorus (care taken not to breach the mucosa underneath)
what is this presentation: 6 months vomiting food then yellow and then green. sausage like mass in the abdomen . blood (red current jelly) in nappy
intussusception
what is intussusception
where bowel acts like a telescope- folds in on itself
what signs suggest intussusception
target sign- looks like a bullseye on ultrasound
pseudo kidney- from opposite view looks like a kidney
what is the treatment for intussusception
radiology push air into colon to blow out the folds- works in 70-80% of cases, if not need surgery
need to be fully resuscitated before this happens- can loose fluids as cant take any in
what is this presentation: 6 years old, stomach pain, painful during bumps in the car, cant jump, mild temperature
appendicitis
unable to jump means they have peritonitis
what investigations into appendicitis
ultrasound
what is the treatment for appendicitis
appendectomy- 95% laparoscopic
what is this presentation: baby vomiting green
EMERGENCY MIGHT BE MALROTATION WITH VOLVULUS
what colour vomit in volvulus, why
green- fairly liquid
due to bile and pancreatic juice
what happens in malrotation
fixed points in abdomen (jejunum and cecum) form the longest line in the abdomen- path of the superior mesentic artery
if this points fixed in wrong place then unstable and can bowels can twist causing a vulvulus
how do you tell if its a vulvulus
contrast scan
what does a blue/ black scrotum suggest
torsion, testicles have died
what can cause the scrotum to be inflamed
infection
what can cause a blue/ black dot on testicles
torted hydatid
what is a hydatid
embryological remnant of the ovarian duct
what cause inflammation on scrotum that goes down to perineum and up into groin
idiopathic scrotal oedema - cures itself
what is Balanitis Xerotica Obliterans (BXO)
when penile head is scarred, white or fissured
what can help loosen foreskin
steroid cream
what is hypospadias
congenital problem where the opening of the urethra is on the underside of the penis
can you differentiate a hydrocele and a hernia in testes via transillumination
no will both glow
