Flashcards in Basics of Umbilical Disorders Deck (25):
What are the umbilical structures and what do they turn into
umbilical vein - round ligament of liver
umbilical arteries - round lig of the bladder
urachus - connects the bladder and allantois
whos at risk for acquired umbilical patent urachus?
Patent urachus can cause
Clinical signs of a patent urachus
moisture around navel
drip or stream from umbilicus when posturing to urinate
Dx of Patent urachus
positive contrast rads
ultrasound* - vesicourachal patency, umbilical or urachal abscess.
Tx of patent urachus
BS AM for up to 5 days. If nothing, surgerize
Indications for surgery
failure to respond to AM
rent in urachus that produces SQ swelling
dissect umbilicus and urachus from body wall
ligate the umbilical vein and cut,
ligate the umbilical arteries and cut (and part of the bladder too)
2-incision pattern to close bladder
lavage abdomen with saline
post-op care for patent urachus
AM 3-5 days
stall rest for 2 weeks
remove sutures at 14 days
CLinical signs of Omphalophlebitis
overt signs of infection
high WBC and fibrinogen
joint infection, diarrhea, penumonia concurrently
Dx of Omphalophlebitis
how long can the vessels in urachal region be seen after birth?
umb vein - 2 months, but should be hypoechoic and
Tx of Omphalophlebitis
BS AM (for up to 2-3 weeks) --> esp chloramphenicol, but the notes say PenGent
re-evaluate every 5-7 days
After care of Omphalophlebitis patients includes
monitoring for evidence of septicemia --> esp joints.
stall rest for 2 weeks
prognosis of Omphalophlebitis
if into liver, poor
Umbilical hernia reasons for forming
failure of umbilical stump to completely heal after birth
- trauma during birth
-umbilical cord infection
3 portions of the Umbilical hernia
1. the ring
2. the hernia sac
3. the contents of an abdominal hernia
Dx of Umbilical hernia
digital palpation - see ring size nature of contents,
DON'T LANCE UNTIL YOU KNOW
An Umbilical hernia is reducable if...
We go to surgery for Umbilical hernia when...
not spont heal in 4 months
greater than 10 cm in diameter
when there is incarceration
any increase in hernia size, firmness, edema, or pain on palpation
Hernia clamps are good right?
GA in dorsal recumbency
expose rectal sheath of rectus abdom muscle
do the technique open or closed,
then simple continuous to close suture
What is the open technique for Umbilical hernias?
the abdomen is entered. to get the guts in the right place that way.
What is the closed technique for Umbilical hernias?
the abdomen is not entered and the hernia is just inverted and sewn up