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Flashcards in Common surgical problems Deck (17)
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1

presentation of pyloric stenosis

recurrent projectile, non-bilious vomiting after feeding

2

general age of presentation of pyloric stenosis

3-6 weeks but may present later

3

investigation for pyloric stenosis

ultrasound scan, may have an upper abdominal mass

4

treatment of pyloric stenosis

IV fluids, pyloromyotomy

5

What is an intussusception?

one piece of bowel 'telescopes' inside another piece of bowel resulting in obstruction and possibly ischaemia

6

most common location for intussusception

distal ileum

7

common age of presentation for intussusception?

3months - 3years, majority before 1 year

8

Risk factors for intussusception

cystic fibrosis, intestinal mass i.e. polyp, lymphoma, meckels diverticulum

9

presentation of intussusception

colicky abdominal pain, sausage shaped mass which is palpable, *red currant jelly stools *, abdominal distention, shock, peritonitis

10

Diagnosis of intussusception

abdominal xray show dilated small bowel +/- the absence of gas in the large bowel

11

Treatment of intussusception

IV fluids, insufflation, surgery

12

What is insufflation?

air is pumped into the anus in an attempt to stretch the walls of the bowel and reduce the intussusception. Successful in 75% and is first line if no peritonitis

13

Patients who will always recieve surgery for intussusception first line?

those with peritonitis

14

What causes intestinal malrotation?

failure of the midgut mesentery to attach to the retroperitoneum and thus cause midgut volvulus or obstruction possibly leading to ischaemia (due to SMA obstruction)

15

Diagnostic factors for intestinal malrotation

bilious vomiting, abdominal pain, <1 year, passage of blood PR

16

Which sign is most concerning in intestinal malrotation?

passage of blood PR is a late sign and suggests necrosis which requires emergency surgical decompression

17

Investigations for intestinal malrotation

*CT with contrast*, plain Abdo XR, USS