surgical problems in children

Question 1

describe the presentation of pyloric stenosis

Answer 1

milk projectile vomiting - not yellow or green
around 6 months

Question 2

how does pyloric stenosis occur and how do you treat it?

Answer 2

pylorus muscle becomes too thick so passage gets too narrow for milk to pass
treat with laprascopic surgery

Question 3

how does intussusception present?

Answer 3

severe pain that you can notice in a baby
green/ yellow vomit
red mucus stool
presents at 3-24 months most commonly
can feel a ‘sausage’ on the abdomen on examination
- child screams then goes floppy
- target sign on ultrasound

Question 4

what is intussusception?

Answer 4

one part of the bowel slides into another part causing tightness of the gut lumen causing obstruction

Question 5

how to you treat paediatric intussusception?

Answer 5

air reduction- enema
surgery if fails

Question 6

what is the telltale sign of appendicitis in children?

Answer 6

pain over speed bumps
if unsure ask them to jump- they won’t in appendicitis

Question 7

what causes painful scrotum with small palpable lump or visible blue dot in children?

Answer 7

Hydatids of Morgagni - left over female genitalia from early development - with torsion
usually resolves on its own but can be surgically removed

Question 8

what is idiopathic scrotal oedema?

Answer 8

red inflamed scrotum and peroneum seen in ages 5-10
not painful but can be itchy

Question 9

what steroid is given for abnormally tight foreskin?

Answer 9

betamethasone

Question 10

what is hypospadias?

Answer 10

a birth defect in boys in which the opening of the urethra is not located at the tip of the penis

treated with surgical resection when child is around 1

Question 11

describe hydrocele

Answer 11

swelling in the scrotum caused by fluid buildup in the sac surrounding the testicles
seen in newborns and often go away without treatment before age 1
textbook sign is they glow under a light but inguinal hernia also do this