surgical problems in childhood

Question 1

baby 6 weeks old:

• baby vomiting milk
• keen to feed
• signs of dehydration
• peristalsis across the abdomen
• may feel a mass
• ultrasound shows thickened muscle layer just beyond stomach (pylorus)

what is the diagnosis?

Answer 1

Pyloric stenosis

Question 2

what is used to treat pyloric stenosis?

Answer 2

incision in pylorus down to the mucosa with either:

• open pyloromyotomy
• laparascopic pyrolocyotomy

Question 3

6 month old baby:
-vomiting and waves of discomfort
-may or may not have stooled, but passage of blood may be reported
-dehydration
-may see or feel mass in abdomen
-red currant jelly looking blood in nappy
-US: target sign (swirly appearance)
what is diagnosis?

Answer 3

Intussusception

Question 4

6 year old:
-vomiting
-felt every bump/turn on the road on the way to the hospital
-moderate temperature
US: shows inflamed appendix
what are diagnosis and treatment?

Answer 4

• appendicitis

- appendicectomy

Question 5

what does green vomiting indicate in children and what investigations can be done?

Answer 5

• bowel rotation
• upper GI contrast
• interoperative twirl seen

Question 6

how to examine a scrotum?

Answer 6

-use a pointer to check if they feel pain in certain areas