4: Common surgical problems in children (notes) Flashcards Preview

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Flashcards in 4: Common surgical problems in children (notes) Deck (34)
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1

What are common presentations requiring paediatric surgery?

Vomiting child

Acute abdomen

Acute scrotum

2

What factor influences the presentations you see in paediatrics?

Age

3

When does pyloric stenosis usually occur?

 

around 6 weeks 

4

What happens in pyloric stenosis?

 

pyloric stenosis causes OBSTRUCTION and abdominal muscle contracts trying to push it into duodenum

 

5

What is the result of pyloric stenosis?

 

abdominal mass, vomiting after eating/drinking

 

6

what happens histologically in pyloric stenosis?

 

abdominal muscle hypertrophies around pyloric stenosis and can be measured on ultrasound

7

what causes the stenosis of pyloric stenosis?

 

hypertrophied circular muscle layer of stomach

8

what is the surgical treatment for pyloric stenosis?

pyloromyotomy

9

what age does intusseption occur usually? 

around 6 months 

10

describe the symptoms of intussuseption

abdominal pain (pulling legs up) > limpness

pale 

struggling to pass stool (which is bloody)

 

 

11

what does the abdominal mass look like in intussuseption?

hard "sausage-shaped" 

"Target sign" (kidney bean laterally) on ultrasound - layers of bowel on top of one another

 

12

what differentiates intussuseption from colic?

paleness, in colic they're pink

13

where does intussuseption occur?

​Occurs around iliocaecal junction and travels along large bowel

14

how is intussuseption treated?

 

air enema

15

Explanation of intussceception

 

bowel is "telescoping" on itself, swelling, then obstructing

16

what age do children suffer from appendicitis? 

 

6 years and older 

17

what type of pain is associated with appendicitis?

 

 

peritonitis 

18

symptoms and signs of appendicitis

 

 

hand on abdomen 

bent over in pain 

cant jump and pain on movement (ask about journey)

low grade fever 

19

what can happen in a viral infection if a viruse is swallowed and accumulates at appendix? 

mesenteric lymphadenitis

20

symptoms and signs of mesenteric lymphadenitis

right inguinal pain like in appendicitis but they can jump!

kids may describe their pain as abdominal and then have pneumonia

 

21

important question to ask kids with abdominal pain 

can they pee normally? 

 

22

what colour is bile when nenonates vomit it?

green due to the digestion by stomach acid

23

what happens in malrotation?

 

 

duodenum and caecum aren't fixed in normal places

allows rotation of large bowel around duodenum (where the bile duct enters)

so bile can enter the stomach and be vomited up

(also the blood supply is cut off and bowel starts to die off due to ischaemia)

24

what to assume in a newborn vomiting bile (green)

 

 

MALROTATION

25

what are the 3 things that most commonly cause acute scrotum in children? 

 

testicular torsion 

epidifymitis 

mullerian duct remnants 

26

what happens in mullerian duct remnants?

blue dot and less pain than torsion 

27

what are the symptoms of idiopathic scrotal oedema?

 

red, swollen, itchy scrotum, rash on groin and perineum

28

is closed foreskin normal?

yes it can be 

29

what is the diagnosis which requires circumcision?

BXO

30

what to do if swelling is ridiculous

squeeze it