GIT Flashcards
(27 cards)
What are the common list of GIT differentials in pediatrics according to age?
Neonates, infants and toddlers:
Congenital causes, prematurity necrotizing enterocolitis, Hirschsprung disease and intestinal obstruction
School-age children:
Idiopathic constitution, infectious causes, functional abdominal pain and abdominal migraine
Adolescents: (conditions related to menstruation)
Testicular torsion, ovarian torsion, IBS and inflammatory bowel disease
What is the most common GI emergency in neonates?
Prematurity necrotizing enterocolitis
What are the common physical examination findings of acute abdomen?
Restlessness = colicky pain (as seen in obstructed viscous)
Abdominal rigidity = as seen in peritoneal process
Constant pain = strangulation of the gut or torsion
What are the physical examination findings of intestinal obstruction?
High pitched bowel sounds, abdominal distension, tenderness and visible peristalsis at times.
What are the physical examination findings of peritonitis?
Diminished or absent bowel sounds, abdominal wall rigidity, involuntary guarding and often rebound tenderness.
What is the most common pediatric emergency?
Appendicitis
peak age 10-12 years of age
What are the common clinical features of appendicitis?
- Periumbilical pain that is then localized to the RLQ
- Vomiting
- Anorexia
- Fever
Upon physical examination, there is tenderness to palpating at the McBurney point
What is the most common cause of acute pancreatitis in children?
Blunt trauma
What is the type of abdominal pain found with pancreatitis?
Periumbilical or epigastric area
What signs can be seen in severe pancreatitis?
Grey turner sign or Cullen sign
Which is more specific for acute pancreatitis, elevation of serum amylase or serum lipase?
Serum lipase
Other lab abnormalities may include leukocytosis, hyperglycemia, hypocalcemia, elevated transaminase and coagulopathy
What is the most common method used for diagnosing and monitoring acute pancreatitis?
Abdominal US
What is cholecystitis?
Inflammation of the gallbladder with transmural edema that may be associated with gallstones, or less commonly, without stones.
What are predisposing conditions of cholecystitis?
Sickles cell disease, CF and prolonged TPN therapy
Where does abdominal pain associated with cholecystitis localize to?
RUQ
What is chronic abdominal pain?
Abdominal pain that occurs each month for at least 3 consecutive months.
What is the classic presentation of functional abdominal pain?
Periumbilical pain
What are organic causes of chronic abdominal pain?
Constipation Peptic ulcer disease Carbohydrate intolerance IBD Pancreatitis Celiac disease H. Pylori infection GU disorders (e.g. pyelonephritis, hydronephrosis) Congenital structural abnormalities of the GI tract (e.g. malrotation, intestinal duplication, hernia)
What are the normal stool patterns?
First week of life = 4x/day
1 year of age = 2x/day
4 years of age = 1x/day
What is the most common form of constipation during childhood?
Functional fecal retention (FFR)
What is the most common cause of organic constipation in an otherwise healthy child?
Hirschsprung disease (a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in functional obstruction)
What is part of maintenance therapy of treating constipation?
Osmotic laxative (polyethylene glycol)
What are causes of organic constipation?
Hirschsprung disease
Neuroenteric dysfunction (secondary to ischemia, trauma, spinal cord abnormality)
Medications (e.g. narcotics or sedatives)
Low-fiber feeding regimens
Anatomical abnormalities (e.g. stricture, adhesion, anteriorly displaced anus)
Systemic diseases (e.g. dehydration, celiac disease, hypothyroidism, CF, DM)
Infant botulism
Lead toxicity
Anorexia nervosa
What is colic?
Crying that lasts >3 hrs/day and occurs >3 days/week
