Surgical Problems in Children Flashcards
6 weeks old with abdominal swellings and severe vomiting?
pyloric stenosis
why do babies vomit in pyloric stenosis?
stomach is peristalsing to push milk through the pylorus but due to a high up obstruction high up in the GI tract it is vomited back up
what colour is the stomach on USS?
black
what confirms pyloric stenosis on USS?
very thick muscle depth
what is the procedure done in pyloric stenosis?
pyloromyotomy
6 month old child with vomiting, no defecation, up at night with pain and then goes limp?
intussusception
what is the classic appearance of stool in intussusception?
bloody like redcurrant jelly
findings on abdo exam of a child with intussusception?
soft in some areas, hard in others
“sausage shaped mass”
how could you differentiate intussusception and colic?
intussusception= pale child that goes limp colic= red, angry child
cause of intussusception?
telescoping and folding of the bowel in on itself causing swelling and obstruction in the terminal ileum and caecum
why is the immune response so high in intussusception?
lots of lymph nodes in terminal ileal / caecal area
what classic sign on USS demonstrates intussusception?
target (bullseye) appearance
how is intussusception treated surgically?
blowing air via the anus to push it along the bowel
6 year old with tummy pain and “hated the journey to the hospital as it was bumpy”
peritonitis
what examination tests should be done to determine if a child needs surgery or not?
ask them to jump- GE kids will be able to, appendicitis kids wont
just try and find the sore area, dont do a full abdo unless necessary
what kind of temperature to kids with a UTI get?
high grade
what kind of temperature do kids with appendicitis get?
low grade
why is it important to do a whole body examination?
a child may associate pain with the wrong area eg abdo pain that is actually chest pain
why shouldnt you say “bile” when talking to patients with bile vomitus?
the colour of it varies so you are better to ask about the colour of the vomit
what bile colour is the most severe?
green
what does green bile indicate?
malrotation
what is malrotation?
gut not sitting in correct orientation that can twist and decrease blood supply via the SMA
where does the obstruction occur in malrotation?
high in the duodenum but below where pyloric stenosis happens
most common cause of acute scrotum?
leftover malarian ducts (female embryological remnant) in boys
how many hours to act on a testicular torsion?
4-6hrs
what has the same presentation as testicular torsion?
epididymitis
what presentation suggests leftover malarian ducts as the cause of an acute scrotum?
blue dot on testes
acute, itchy scrotum with redness that radiates to the groin and perineum?
idiopathic scrotal oedema
treatment for idiopathic scrotal oedema?
antihistamines and pain relief
most common abnormality of the GU tract in boys?
hysospadus
