bilous vomiting- malrotation Flashcards
assocation with duodenal atresia 1
downs syndrome
age at presentation of duodenal atresia
few hours after birth
main syx of duodenal atresia
bilious vomit
diagnosis of duodenal atresia 2
AXR
-shows double bubble sign
-contrast study to confrim
treatment for duodenal atresia
duodenoduodenostomy
cause of jejunal/ ileal atresia
vascular insufficinecy in utero
age at persenation of jejunal/ ileal atresia
within 24 hours of birth
main syx of jejunal/ ileal atresia 1
bilious vomint
diagnosis and treatment of jejunal/ ileal atresia
AXR- shwos air-fluid leveels
-laparotomy with primary resection and anastomosis
define malrotation of the gut
intestinal rotation and fixation that should occur between 4-12th weeks gestation does not
what is the normal anatomical position of the DJ flexure, caecum and the trasnverse colon
DJ flexure- left of midline
caecum- RIF
trassnverse colon- anterior to small bowel mesentery
what is the most common abnormaity in malrotation of the gut
-what does this cause
caecum lies close to DJ flexure
-abnormally narrow midgut mesentery which is liable to twist-> volvulus SURGICAL EMERGENCY
when does malrotation of the gut ususally occur
-how does it present
3-7 days after birth
volvulus w compormised circulation may cause periotneal signs and haemodynamic instabiltity
diagnosis of malrotation of the gut 2
Upper Gi contrast study
-shows DJ flexure more medially placed
USS may show abnormal orientation of SMA and SMV
treatment of malrotation of the gut
AFTER RESUSCITATION-> Ladds procedure
-the intestine is straightened out, the Ladd’s bands are divided, the small intestine is folded into the right side of the abdomen, and the colon is placed on the left side
