vomiting nonbilious- pyloirc stenosis

Question 1

vomiting baby
-questions to ask in a history 5

Answer 1

bilious ie is it green (fairy liquid green)

projectile

hows feeding

weight gain

temp or rash?

Question 2

top 5 causes of a vomiting baby

Answer 2

1. Overfeeding
2. Possetting (regurg milk)
3. Gastro-oesophageal Reflux
4. Pyloric stenosis
5. Obstruction (Bilious vomiting is obstruction until proven otherwise)

Question 3

what is bililous vomiting until proven otherwise in a child
-what needs done immediately

Answer 3

an obstruction

SURGICAL EMERGENCY

Question 4

prinicples of mangement of pyloric stenosis 4

*type of surgery completed

Answer 4

1. History
2. Examination
3. Ultrasound
4. Biochemical correction and NGT

*pyloromyotomy

Question 5

age of onset of pyloric stenosis

Answer 5

2-6 weeks

Question 6

M:F of pyloric stenosis

Answer 6

5:1

Question 7

presenation of pyloric stenosis

Answer 7

1. rapidly progressive projectile vomiting without bile, soon after feeds NO BILE
2. hungry baby
3. acute weight loss
4. dehydration

Question 8

biochem abnormalites in pyloric stenosis 2

*ABG?

Answer 8

hypokaelaemic
hypochloraemic

*-metabolic alkalosis

Question 9

diagnosis of pyloric stenosis 1
-what should be assessed in this test 2

Answer 9

do a test feed

-look for visibile peristalsis
-palpable pylorisi muscle (olive in RUQ)

Question 10

management of pyloric stenosis 2

Answer 10

correct electrolyte imbalce with IV fluids

surgery -pyloromyotomy

Question 11

causes of bilious vomiting in a baby 5

Answer 11

1. Malrotation +/- volvulus until proven otherwise
2. NEC (Necrotising Enterocolitis)
3. Atresia (oesophageal/ duodenal)
4. Hirschsprungs disease (Aganglionic Megacolon)
5. Meconium disease i.e. meconium ileus, meconium plug syndrome

Question 12

what is bilious vomiting in a child until proven otherwise

Answer 12

malrotation ± volvulus