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Flashcards in General Surgery Deck (29)
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1

criteria for diagnosis of pyloric stenosis

US that shows length of pylorus >= 14 mm, thickness >= 4mm

2

metabolic disturbance in pyloric stenosis

metabolic alkalosis, paradoxical aciduria

3

most common type of intussuception

ileo-colic (85%)
(ileo-ileal 10%)

4

recurrence rate of intussusception

3-11% (most often within 24 hrs after reduction)

5

what finding do you see on u/s in intussusception

target sign

6

treatment of intussusception

pneumatic reduction

7

characteristics of meckel's

2% of population, 2% symptomatic, 2 feet of IC valve, 2 inches long

8

diagnosis of meckel's

technicium 99 scan (meckel's scan) - detects gastric mucosa, can give ranitidine before to suppress acid in stomach and pick up ectopic gastric mucosa better!

9

diagnostic test for malrotation with volvulus

upper GI series

10

what do you see on upper GI in context of midgut volvulus

should see ligament of treitz at the level of the pylorus, to the left of the spine (C-loop)

11

components of ladd's procedure

- detort volvulus
- lyse Ladd's bands
- widen mesentery
- remove appendix

12

ddx bilious vomiting

- midgut volvulus
- malrotation
- duodenal or other atresia
- hirschsprung's
- ileus

13

cardinal signs of hirschprung's

failure to pass meconium within 24 hours, abdominal distension, bilious vomiting

14

management of hirschprung's

- insertion of rectal tube with saline irrigations
- antibiotics if signs of enterocolitis
- surgery: pull-through

15

most common cardiac anomaly associated with omphalocele

tetrology of fallot

16

where is the defect in the abdo wall with gastroschisis?

right of umbilicus

17

abdominal wall defect with peritoneal sac

omphalocele

18

abdominal wall defect associated with other congenital anomalies

omphalocele

19

infants with inguinal hernia: indication for bilateral exploration

prematurity

20

increased risk of hernia incarceration with a wait time after diagnosis of....

> 30 days

21

complications of inguinal hernia repair

- scrotal swelling/hermatoma
- iatrogenic undescended testicle
- recurrence
- injury to vas deferens
- testicular atrophy

22

main indication for orchidopexy

risk of infertility

23

risk of undescended testicle

fertility, malignancy, torsion/hernia

24

undescended testicle: when to refer to surgery

9 months of age, should have surgery around 1 year

25

How do you diagnose Hirschprungs?

Rectal biopsy

26

What is seen on a rectal biopsy in Hirschprungs?

absence of ganglion cells
hypertrophic nerves
Increased acetylcholine staining

27

What is associated with omphalocele?

Cardiac defects (most common: tetrology of fallot)

28

What is associated with gastroschesis?

intestinal atresia

29

What might you see on contrast enema in Hirschprungs?

transition zone (usually recto-sigmoid)