Surgical Problems in Childhood

Question 1

define pyloric stenosis

Answer 1

thickening of the stomach wall which prevents passage into the small bowel

Question 2

presentation of pyloric stenosis

Answer 2

projectile milky vomit at around 6 weeks

bumps on abdomen with waves of peristalsis

Question 3

diagnosis of pyloric stenosis

Answer 3

increased thickening of the muscle

Question 4

risk in pyloric stenosis

Answer 4

risk of acid loss leading to metabolic alkalosis

Question 5

management of pyloric stenosis

Answer 5

fluids

surgery (slice muscle- risk perforation)

Question 6

define intussusception

Answer 6

this is when a bit of bowel telescopes on itself (sleeve roll)

Question 7

cause of intussusception

Answer 7

inflammation of Peyer’s patches leading to irritation and bowel movement

Question 8

presentation of intussusception

Answer 8

6 month old with abdominal pain in cycles
poor feeding
vomit with food and green colour
little stool passage, often with red currant jelly-like blood
bumps on abdomen in mid-gut region that feel like sausages

Question 9

diagnosis of intussusception

Answer 9

USS shows target lesion and pseudo-kidney

Question 10

management of intussusception

Answer 10

surgery

radiology blow air up anal canal

Question 11

define peritonitis

Answer 11

inflammation of the peritoneum

Question 12

presentation of peritonitis

Answer 12

abdominal pain (jumping)
temperature

Question 13

diagnosis of peritonitis

Answer 13

clinical

USS show thickened wall

Question 14

management of peritonitis

Answer 14

removal of peritoneum

Question 15

describe testicular torsion

Answer 15

sore, surgical emergency due to risk of testicular death (4 hours)

Question 16

describe twisting of hydatid of Morgagni

Answer 16

ovarian duct structure
blue dot
pain

Question 17

describe idiopathic scrotal oedema

Answer 17

redness in scrotum that can extend to groin
achy
tissue can look waterlogged
no surgery

Question 18

describe BXO (balanitis xerotica obliterans)

Answer 18

white scar over end of penis that can extend into the urethra
manage with circumcision

Question 19

define hypospadias

Answer 19

urethra is not coming out of the tip of the penis
hole can be anywhere along the shaft
congenital abnormality
elective surgery

Question 20

patent processus vaginalis

Answer 20

canal does not close where the testes descend
fluid accumulation at the end of the day
tends to be gone by 4