Flashcards in EXAM #3: PEDIATRIC SURGICAL PROBLEMS Deck (43)
What are the three etiologies of lymphadenopathy?
What is the difference between acute and chronic lymphadenopathy?
- Less than 6 weeks= acute
- Greater than 6 weeks= chronic
What is the surgical procedure to diagnose lymphadenopathy?
What do you need to do for the proper diagnosis of a thryoglossal duct cyst?
US to ensure there is normal thyroid tissue
What is the surgical procedure for a thyroglossal duct cyst?
A small incision is made over the cyst. The cyst and the entire tract are removed, as well as the middle portion of the hyoid bone
When is surgery indicated for congenital torticollis?
Failure to resolve within a year with aggressive conservative therapy
How is congenital torticollis treated surgically?
Division of the involved SCM
What is the most common type of tracheo-esophageal fistula?
Proximal atresia with distal fistula
What is the most common presenting symptom of a TE fistula?
How is a TE fistula managed surgically?
Right toracotomy and exptrapleural repair
*May require gastrostomy
What is the VATER association with TE fistula? Why is this important?
Any kid with a TE fistula will need to be associated for these issues as well.
What is the eponym for the most common location of a diaphragmatic hernia?
Foramen of Bochdalek in the left pleuroperitoneal membrane
When do you know if a chest wall deformity needs to be repaired?
At least 14 years of age--only intervene earlier if cardiopulmonary compromise
What anomalies are associated with omphalocele?
2) Urinary Tract
What is the difference between major and minor omphalocele?
Minor= less than 4cm
Major= greater than 4cm
What is Bechwith-Wiedeman Syndrome?
This is an overgrowth disorder usually present at birth; it is characterized by an increased risk of childhood cancer and congenital anomalies, including:
1) macroglossia (large tongue),
2) macrosomia (above average birth weight and length),
3) midline abdominal wall defects (omphalocele/exomphalos, umbilical hernia, diastasis recti),
4) ear creases or ear pits, and
5) neonatal hypoglycemia
What is Gastrochisis?
Abdominal wall defect right of the umbilicus
What is worse, gastrochisis or omphalocele?
What are the complications of gastrochisis and omphalocele?
1) Heat loss-->warm
2) Third space heat loss
At birth, what should you remember about gastrochisis or omphalocele?
Leave the umbilical cord long
What is the presentation with malrotation and volvulus?
Forceful often bilious emesis
*Remember, bilious emesis is a red flag*
How do you diagnose malrotation/ volvulus?
Upper GI series
What is the classic imaging for duodenal atresia?
"Double bubble sign"
How is duodenal atresia repaired surgically?
What causes midgut atresia?
In utero mesenteric vascular accident
What is the rule of two's for Meckel's Diverticumlum?
- 2 feet from ileocecal valve
- 2% population
- Most before age of 2
How does Meckel's Diverticulum present?
What is the first thing you need to do if you suspect Meckel's Diverticulum?
2) Meckel's Scan
How do you work-up Hirschsprung's Disease?
1) Barium enema
2) Rectal biopsy* gold-standard