Surgical Problems in Neonates

Question 1

what is the result of gut perforation?

Answer 1

large amount of gas in the abdomen

Question 2

what is Wrigley’s sign?

Answer 2

gas on both sides of the bowel wall which makes the circles appear very clearly

Question 3

what is the underlying problems in the main problems with the gut?

Answer 3

something gets stuck in the lumen
issue with the bowel wall
something pushing from the outside

Question 4

if something was stuck in the lumen, how would the stomach feel?

Answer 4

distended and doughy

Question 5

symptoms when something is stuck in the lumen

Answer 5

vomiting

not emptying bowels

Question 6

what is the soap bubble sign?

Answer 6

dye that does not look a solid colour within the bowels

Question 7

what would the x ray look like in bowel obstruction?

Answer 7

soap bubble sign

loops that are bigger than they should be

Question 8

what is a common problem of the bowels in cystic fibrosis?

Answer 8

meconium ileus

- stickiness in the bowel creating an obstruction

Question 9

what is the main issue that can occur with the bowel wall?

Answer 9

atresia of the gut

Question 10

classic case of atresia of the gut

Answer 10

gut didn’t look right prenatally

begins vomiting within 6 hours and poos but only a little bit

Question 11

what is the key for the normal size of bowel loops on an X-ray?

Answer 11

should be the same as the width of the vertebra

Question 12

what causes bowel distension in atresia?

Answer 12

the dead end in the bowel wall

Question 13

what is a sign that can easily be missed of a hernia?

Answer 13

groin crease missing (this is also where the incision is)

Question 14

why can perforation occur in hernias?

Answer 14

canal is too tight

Question 15

what is laddering of the bowels on an x ray?

Answer 15

a sign of obstruction when the bowel loops line up

Question 16

what colour is bile when it is vomited?

Answer 16

mossy green colour

Question 17

what is the main red flag symptom requiring immediate neonatal surgery?

Answer 17

bile vomiting

if you don’t act asap the bowel will die

Question 18

what happens in malrotation with volvulus?

Answer 18

(bile vomiting)

duodenum has gone across the spine to the left side, gone to the middle and twisted

Question 19

what invx should be done in bile vomiting?

Answer 19

upper GI contrast with follow through

Question 20

what is the concern with malrotation with volvulus

Answer 20

if the bowel obstructs the superior mesenteric artery it cuts off the blood supply to the entire midgut