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MIDS 127 - abdo > The Gastrointestinal Tract (Paeds) > Flashcards

The Gastrointestinal Tract (Paeds) Flashcards

1
Q

What is the normal measurement for the paeds gastric wall?

A

2.5 - 3.5mm

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2
Q

What is the measurement for gastric wall thickening in paeds?

A

5-15mm

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3
Q

Pyloric Stenosis is most common in which population?

A

First born male infants between 2-10 wks of age

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4
Q

What are the signs of symptoms of Pyloric Stenosis?

A

Projectile vomiting, dehydration, failure to thrive, palpation of an olive-sized mass at the epigastrium

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5
Q

What are the sonographic appearances for Pyloric Stenosis?

A

Short axis: donut/bagel sign
Longitudinal axis: cervix sign

Length of the antrum to the distal end of the channel is greater than 16mm

Muscle thickness is GREATER THAN or EQUAL TO 3mm.

Stomach is typically not empty, even if pt has been fasting

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6
Q

What is a bezoar?

A

Undigested material causing gastric or intestinal obstruction

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7
Q

What are the 3 types of bezoars?

A

Lactobezoar: most common type in infants, consists of inspissated milk or formula
Phytobezoar: poorly digested plants or veggies
Trichobezoar: ingested hair

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8
Q

Which is more common: intrinsic or extrinsic causes for bowel disease in infancy?

A

Intrinsic.

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9
Q

Intrinsic bowel diseases in infancy include:

A

Duodenal atresia, duodenal web, and duodenal stenosis

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10
Q

Extrinsic bowel disease may include:

A

Malrotation, duodenal duplication cyst, choledochal cyst, annular pancreas

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11
Q

What is the sonographic appearance of small bowel obstruction?

A

Hyperactive dilated bowel loops with bowel wall thickening (greater than 2mm)

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12
Q

What is the most common bowel disease in infancy?

A

Jejunal/ileal Atresia

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13
Q

Duodenal atresia is common in patients with trisomy __.

A

21

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14
Q

What is the sonographic appearance of duodenal atresia?

A

Dilated duodenum and stomach, esophagus may also be dilated

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15
Q

What is the common population for jejunal/ileal atresia and its signs and symptoms?

A

Neonates.

Bilious vomiting, abdo distension, failure to pass meconium (goo)

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16
Q

Jejunal/ileal atresia is associated with:

A

Midgut malrotation, duodenal atresia

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17
Q

What is the sonographic appearance of jejunal/ileal atresia?

A

Multiple dilated loops of bowel with active peristalsis

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18
Q

What is meconium ileus?

A

Neonatal bowel obstruction due to abnormally thick meconium (goo) in distal small bowel. Associated with CF (cystic fibrosis)

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19
Q

Meconium Ilesus has increased or decreased peristalsis?

A

Decreased. Echogenic bowel contents, dilated bowel loops.

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20
Q

Malrotation (etiology, s/s, complications, sonographic appearance)

A

It’s when something in the fetal gut goes wrong during development. Usually diagnosed in the first year of life.

SS: bilious vomiting
Complications: volvulus
SA: abnormal relation of the SMV and SMA

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21
Q

Normally, the SMV is the right of SMA. True or false?

A

True.

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22
Q

What is Volvulus?

A

When the bowel twists on itself and causes bowel obstruction (the SMV will then wrap around the SMA like a snake)

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23
Q

Volvulus is a complication of _________ ______.

A

Malrotated bowel

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24
Q

What are the complications and sonographic appearance of volvulus?

A

Complications: bowel obstruction and ischemia
SA: whirlpool sign on gray-scale and colour doppler (due to the SMV wrapping around the SMA)

25
Q

What is NEC?

A

Necrotizing Enterocolitis, the bowel undergoes necrosis

26
Q

NEC presents often in which population?

A

Premature infants

27
Q

What is the sonographic appearance of Necrotizing Enterocolitis (NEC)?

A

Intraluminal gas, loss of normal hypoechoic muscularis halo, thickened bowel wall, potential free intraperitoneal gas

28
Q

What is Hurschsprung Disease? AKA aganglionic megacolon?

A

Congenital absence of parasympathetic ganglion cells in the submucosal and intramuscular plexuses (bowel becomes dilated, no peristaltic action)

29
Q

Hirschsprung Disease is most common in boys or girls?

A

Boys

30
Q

Hirschsprung disease most commonly affects the _______.

A

Rectosigmoid

31
Q

Hirschsprung Disease is associated with _______ 21.

A

Trisomy

32
Q

What is the sonographic appearance of Hirschsprung disease?

A

Dilated bowel loops which might be echogenic from goo (meconium)

33
Q

What is Meckel Diverticulum?

A

The most common congenital abnormality of the small intestine.

Features painless rectal bleeding!

34
Q

Meckel Diverticulum has which complications and has an appearance of what?

A

Complications: infection, bowel obstruction, intussusception

SA: Blind-ending out-pouching of ileum.

35
Q

What is the most common type of intussusception?

A

Ileocolic: ileum prolapses into the ascending colon

36
Q

What is the most common obstructive bowel disorder of early childhood?

A

Intussusception

37
Q

Intussusception is most commonly ____pathic.

A

idiopathic

38
Q

What is the risk factor for Intussusception?

A

Previous surgery, cystic fibrosis, and appendicitis

39
Q

Intussusception is most common in boys or girls?

A

Boys aged 1-3 y/o.

40
Q

What are the signs of symptoms of intussusception?

A

Colicky abdo pain, bloody black currant stool, distension, vomiting, palpable abdo mass

41
Q

What are the sonographic appearances of Intussusception?

A

Short axis: target pattern or donut sign
Long axis: Pseudokidney sign (looks like a kidney!

Distal bowel appears thin, fluid may appear centrally, and prox bowel appears inflammed and compresses bowel lumen creating a HYPOechoic ring with increased CENTRAL echogenicity

42
Q

Duplication Cysts are most commonly found in the:

A

ileum

43
Q

Duplication cysts are…

A

Benign cysts located along the mesenteric border of the bowel but don’t communicate with the bowel

44
Q

What are the signs and symptoms of duplication cysts?

A

Abdo pain and distension, vomiting, rectal bleeding

45
Q

What are the complications of duplication cysts?

A

Intussusception, pancreatitis (if near ampulla of vater)

46
Q

Lymphoma is the most common…

A

malignant mass of the small bowel

47
Q

Lymphoma most commonly affects which part of the small bowel?

A

The ileum

48
Q

Lymphoma is most commonly (Hodgkin or non-Hodgkin?)

A

Non-Hodgkin

49
Q

What are the signs and symptoms of Lymphoma?

A

Palpable abdo mass, abdo pain, vomiting

50
Q

What are the complications of lymphoma in the paeds population?

A

Intussusception

51
Q

What is the sonographic appearance of lymphoma in paeds?

A

Hypoechoic bowel wall thickening or focal hypoechoic or complex mass with areas of necrosis, bowel lumen may be narrowed, potential splenomegaly and enlarged retroperitoneal and mesenteric lymph nodes

52
Q

What is the most common condition requiring emergency surgery for paeds pop?

A

Appendicitis

53
Q

Appendicitis is most common in which population and age range?

A

5-15y/o, can occur at 3 months old, male prevalence

54
Q

What are the signs and symptoms of Appendicitis?

A

Rebound tenderness over McBurney’s sign, abdo tenderness, fever, leukocytosis, diarrhea, nausea and vomiting

55
Q

What are the complications to appendicitis?

A

Abscess, phlegmon, peritonitis

56
Q

How fast is the progression of acute appendicitis to perforation?

A

6-12 hrs

57
Q

What is the sonographic findings for Appendicitis?

A

Appendix may not longer be visualized or not dilated, echogenic mucosa, increased echogenicity or periappendiceal mesentery, and a complex or fluid filled focal collection (periappendiceal abscess)

58
Q

Where is the appendix visualized?

A

Anterior and medial to psoas muscle, lateral to iliac vessels, and at the base of the cecal tip. Comes off posteromedial (inferior) at the ileocecal junction.

59
Q

What is the sonographic appearance of appendicitis?

A

Non compressible, greater than 6mm AP, hyperemic walls (colour doppler). May be tortuous.

May have appendicolith: echogenic focus with acoustic shadowing

Inflamed periappendiceal fat (echogenic fat). Free fluid. Potential abscess, Enlarged lymph nodes.

MIDS 127 - abdo (14 decks)

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