Malrotation And Intestinal Atresia Flashcards
Quiz Questions:
1. What is the purpose of the Ladd bands in malrotation?
a) To attach the cecum to the liver and peritoneum
b) To attach the duodenum to the peritoneum
c) To rotate the midgut counterclockwise
d) To obstruct the venous drainage of the gut
2. What percentage of children with malrotation present with symptoms of bilious vomiting?
a) 20%
b) 40%
c) 60%
d) 80%
3. When does bilious vomiting typically occur in children with malrotation?
a) During the first week of life
b) During the first month of life
c) During the second month of life
d) During the third month of life
4. What is the main cause of ischemia, pain, tenderness, and bloody emesis and stools in midgut volvulus?
a) Obstruction by Ladd bands
b) Impaired venous drainage of the gut
c) Abnormal placement of the cecum
d) Congestion in the superior mesenteric artery
5. Which imaging study can confirm the diagnosis of malrotation?
a) Plain abdominal x-rays
b) Abdominal ultrasound
c) Upper GI series
d) Follow-through (contrast enema)
6. What is the treatment for malrotation?
a) Medication to relieve symptoms
b) Non-surgical repositioning of the bowels
c) Surgical untwisting of the bowel and division of abnormal attachments
d) Physical therapy to improve gut motility
7. At what stage of fetal life does the midgut begin to loop outward into the umbilical cord?
a) 4 weeks
b) 8 weeks
c) 10 weeks
d) 12 weeks
8. Which artery does the bowel rotate around during midgut rotation?
a) Superior mesenteric artery
b) Inferior mesenteric artery
c) Renal artery
d) Hepatic artery
9. What happens to the duodenum during midgut rotation?
a) It terminates at the ligament of Treitz
b) It remains on the left side of the abdomen
c) It becomes the cecum
d) It loops outward into the umbilical cord
10. What is the significance of malrotation in relation to volvulus?
a) It increases the risk of volvulus
b) It prevents the occurrence of volvulus
c) It has no impact on the occurrence of volvulus
d) It decreases the risk of volvulus
11. What does a plain abdominal x-ray generally show in cases of malrotation?
a) Evidence of obstruction
b) Evidence of malrotation
c) Absence of a typical duodenal “C-loop”
d) Placement of the cecum on the left side of the abdomen
12. What does an upper GI series reveal in cases of malrotation?
a) Obstruction by Ladd bands
b) Absence of a typical duodenal “C-loop”
c) Placement of the duodenum on the right side of the abdomen
d) Abnormal placement of the cecum
13. Which quadrant of the abdomen does the cecum normally reside in?
a) Right upper quadrant
b) Left upper quadrant
c) Right lower quadrant
d) Left lower quadrant
14. When do 40% of children with malrotation typically present with symptoms?
a) During the first month of life
b) During the second month of life
c) During the third month of life
d) During infancy or childhood
15) what are the diagnostic tools of malrotation
Imaging Studies:
❖ Plain abdominal x-rays generally show evidence of obstruction.
❖ Abdominal ultrasound may show evidence of malrotation.
❖ An upper GI series shows: ➢ The absence of a typical duodenal “C-loop” ➢ The duodenum remaining on the right side of the abdomen.
❖ Follow-through (or by contrast enema): ➢ Abnormal placement of the cecum confirms the diagnosis
Answer Key: 1. A) To attach the cecum to the liver and peritoneum 2. c) 60% 3. b) During the first month of life 4. b) Impaired venous drainage of the gut 5. D) follow through 6. c) Surgical untwisting of the bowel and division of abnormal attachments 7. c) 10 weeks 8. a) Superior mesenteric artery 9. a) It terminates at the ligament of Treitz 10. a) It increases the risk of volvulus 11. a) Evidence of obstruction 12. b) Absence of a typical duodenal “C-loop” 13. c) Right lower quadrant 14. d) During infancy or childhood 15. c) The termination point of the duodenum
What is intestinal atresia?
a) A viral infection of the intestine
b) A developmental defect causing a partial or complete blockage of the intestine
c) A type of autoimmune disease
d) A bacterial infection in the digestive system
Approximately, how common is intestinal atresia in live births?
a) 1 in 50 live births
b) 1 in 150 live births
c) 1 in 500 live births
d) 1 in 1,500 live births
Which condition is most commonly associated with duodenal atresia?
a) Cleft palate
b) Down syndrome
c) Heart defects
d) Respiratory distress syndrome
What are the typical clinical manifestations of intestinal atresia in the newborn period?
a) Yellowing of the skin (jaundice)
b) Seizures
c) Bilious vomiting ,abdominal distention and history of polyhydraminos
d) Rapid weight gain
How does duodenal atresia appear on plain abdominal x-rays?
a) Single bubble sign
b) Triple bubble sign
c) Double-bubble sign
d) No specific signs on x-rays
What is the primary treatment for intestinal atresia?
a) Medication
b) Radiation therapy
c) Surgical intervention
d) Physical therapy
Before surgical treatment for intestinal atresia, what should be done to stabilize the patient?
a) Administer pain relief medication
b) Begin immunotherapy
c) Provide IV fluids, nasogastric suction, and antibiotics
d) Schedule a follow-up
When obstruction is complete or high grade:
The end result of intestinal atresia is:
In intestinal atresia If intestinal perforation is present :
B
D
B(Duodenal atresia: Associated with other anomalies in more than half of infants)
C
C
C
C
Bilious vomiting & abdominal distention are present in the newborn period
obstruction with upstream dilation of the bowel and small, disused intestine distally
peritonitis and sepsis may develop
