GI Disorders Flashcards
(37 cards)
What are GERD investigations?
Barium swallow
24 hr esophageal ph monitoring
Impedance monitoring (manometry)
Esophageal endoscopy :erosive esophagitis
GERD management
- not compicated : lifestyle modifications
- complicated: pro kinetics, H2 blockers( ranitidine), PPI
- surgical
What is the peak age for Functional childhood Abdominal pain?
8-9 years
What is the diagnostic investigation of IBD in children?
Endoscopy and Biopsy
What is the management of crohns disease?
First line : enteral nutrition(polymeric diet), 5asa, prednisolone
Second line: AZAthioprine ; MTX
Third line: infliximab ; surgery
What is the pathological finding of a biopsy of celiac disease
Villous atrophy on a jujenal biopsy
What is the serology test to do in celiac disease
Anti-tissue transglutaminase IgA
Endomesial antibodies
Anti gliadin
When should infants regain birth weight after losing it?
By 2 weeks
What are the energy needs of infants?
Ø0 – 3 months 115Kcal/kg/day.
Ø1 – 3 years 95 Kcal/kg/day
Dysphagia associated with achalasia is for what type of food?
Solids & liquids
Investigations of Achalasia
CXR: air fluid level in dilated esophagus
Barium swallow: bird peak appearance
Manometry: increased intra esophageal pressure
Upper endoscopy
Treatment of Achalasia
Endoscopy pneumatic dilatation
Myotomy: laparoscopic, endoscopic, surgical
Botulinum toxin injection (temporary)
What is the peal age for foreign body ingestion in children
6 months - 3yrs
Treatment of Foreign Body ingestion
Fortunately, most ingested FBs pass
spontaneously. Only 10 – 20% require endoscopic
removal, and < 1% require surgical intervention.
What is the role of upper GI series (barium or gastrograffin) swallow) in corrosive injuries
Not valuable in the initial stages of evaluation, only if clinical
suspicion of perforation (use water-soluble contrast not barium).
§ 2-3 weeks post-ingestion, even if the patient is asymptomatic to
evaluate stricture.
Investigations of caustic ingestion
CXR
Endoscopy to all symptomatic pts within 24 hrs (not<6 hrs)
Upper GI series (no major role before 2 weeks)
Treatment of caustic ingestion
Hospital admission & IV Fluids: till evaluation.
v Feeding:
Ø Nasogastric tube: extensive circumferential burns.
Ø Gastrostomy tube: severe extensive esophageal burns.
Ø Jujenostomy tube
v Medications:
Ø Antibiotics: If infection suspected or as prophylasis.
Ø Acid suppression: PPIs.
Ø Corticosteroids: may reduce risk of stricture (Controversial).
v Treatment of complications:
Ø Esophageal dilatation: for strictures 3-6 wks after injury.
Ø Surgical: for perforation and reconstruction of esophagus (If
needed).
What is Rumination syndrome
people repeatedly & unintentionally
regurgitate undigested or partially digested food from the stomach, re-
Swallow it or spit it out,
it most often occurs in infants and very young
children (3-12 months), and in children with intellectual disabilities.
If projectile vomiting presents at 2–7 weeks of age, what disease should be excluded?
Pyloric stenosis
Cl/p of CHPS
§ Non-bilious projectile vomiting, then child is hungry.
§ Olive-shaped palpable mass in Rt upper abd. quadrant.
§ Gastric peristaltic waves (Lt to Rt) in baby’s abdomen.
What is the finding of a barium meal in a baby with pyloric stenosis?
String sign
Investigations of CHPS
§ Hypochloremic metabolic alkalosis with a low Na & K as
result of vomiting.
§ Abd. Ultrasound: Pylorus: ► > 4mm wall thickness.
► > 15mm length.
§ Barium meal ± (in doubtful cases): Narrow pyloric canal
(String sign).
Management of CHPS
§ The initial priority: correct any fluid and
electrolyte disturbance with IV fluids (0.9% saline
and 5% dextrose with K supplements).
§ Definitive treatment by pyloromyotomy:
ØDivision of the hypertrophied muscle down to, but
not including, the mucosa.
ØEither by open procedure or laparoscopically.
§ Postoperatively, the child can usually be fed within
6 hrs and discharged within 2 days of surgery
What is sandifer syndrome?
Dystonic head and neck. Movements
A complication of GERD
