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MD 3 - Paeds > Abdominal pain > Flashcards

Flashcards in Abdominal pain Deck (32):
1

treatment of pyloric stenosis

- Resuscitate
- surgery (division of the hypertrophic muscle)

2

aetiology of pyloric stenosis

due to the progressive hypertrophy of the circumferential muscle layer of the pylorus --> outlet obstruction

3

medical causes of constipation in children

cows milk allergy
coeliac disease
hypercalcaemia
hypothyroidism

4

"typical" patient demographics with pyloric stenosis

male, 3-6 weeks of age with a family history

5

a double bubble sign on xray is pointing to which Dx

malrotation with volvulus or dueodenal atresia

6

clinical presentation of malrotation with volvulus

bile stained vomiting!
- feeding difficulties, typically in the first week
late signs: PR bleeding, abdominal distension, abdominal tenderness

7

7 most common causes of abdominal pain in neonates

Hirschprung's
intussuception
incarcerated hernia
irritable infant
Meckel's diverticulum
UTI
volvulus

8

what is Meckel's diverticulum

remnant of vitelline duct that connects the yolk sac with the primitive midgut

9

signs on examination of pyloric stenosis

visible peristalsis
palpable olive at the pylorus
dehydration

10

what is intussusception

invagination of the proximal bowel into the distal bowel

11

most common cause of intussusception

inflamed peyer's patches in the terminal ileum

12

what is the ABG derrangement that pyloric stenosis can cause

hypochloraemic, hypokalaemic, metabolic alkalosis

13

treatment for malrotation with volvulus

Surgery!
- deliver the bowel through the tummy
- untwist in an anticlockwise rotation
- place the gut back in
- widen the mesentry
- appendectomy

14

DDx of non-bilious vomiting in neonatal period

- pyloric stenosis
- sepsis
- reflux
- over feeding
- metabolic diseases - rare
- CAH - rare

15

gold standard investigation for intussusception

ultrasound - see target sign

16

Age group for intussusception

3 months to 3 years
- Peaks at 5-11 months

17

clinical presentation of intussusception

- intermittent abdominal pain
- vomiting
- lethargy
- red currant stools (late sign)

18

what are some pathological lead points that can lead to intussusception

Meckel's diverticulum
polyp
vascular malformation
duplication cyst

19

6 most common causes of abdominal pain in infants/preschool

appendicitis
gastroenteritis
pneumonia
UTI
volvulus
constipation

20

classical presentation of appendicitis

- periumbilical pain moving to the RIF
- vomiting
- anorexia
- guarding RIF
- fever
- lying still

21

what degree of twist of malrotation with cause arterial ischaemia

720 degrees

22

surgical causes of constipation in children

hirschprung disease
meconium ileus
anatomical malformation of the anus
spinal cord abnormalities

23

what time of the year is intussusception most common

spring and autumn

24

investigations for malrotation and voluvlus

upper GI contrast study - gold standard

25

DDx of BILIOUS vomiting

- malrotation with volvulus
- duodenal atresia
- jejunoileal atresia
- meconium ileus
- necrotizing enterocolitis
- intussusception
- incarcerated hernia
- Hirschprung's disease

26

treatment of intussusception

- simple intussusception = air enema reduction
- complicated intussusception = laparotomy

27

what signs on examination point to intussusception

palpable mass
pulling their legs up
pallor
dehydration

28

consequences of intussusception

- dehydration
- bowel obstruction
- bowel ischaemia --> perforation

29

peak age group of appendicitis

10-12

30

aeitology of malrotation with volvulus

narrow base of mesentry between the ileocaecal junction and the duodeno-jejunal junction --> allowing the gut to twist around the superior mesenteric vessels

31

when should you start feeds again after pyloric stenosis surgery

6 hours

32

clinical presentation of pyloric stenosis

- forceful, projectile, non bilious vomiting
- vomiting after every feed
- effortless
- hungry straight afterwoods
- decreased stooling
- weight loss