Flashcards in Musckovitz: GI Developmental Cases Deck (18):
3 week infant w/ projectile vomiting immediately after fed that looks like breast milk. Mobile mass mid xiphoid. Jaundiced.
Congenital hypertrophic pyloric stenosis
What causes congenital hypertrophic pyloric stenosis?
hypertrophy of the muscles at the distal end of hte stomach
How do you treat congenital hypertrophic pyloric stenosis?
Call a surgeon to perform the Ramstedt procedure
Why is a baby w/ congenital hypertrophic pyloric stenosis jaundiced?
Starvation increases the enterohepatic recirculation of bilirubin
What are the RFs for congenital hypertrophic pyloric stenosis?
First born M
SE of erythromycin in infants
17 d old M, bilous vomiting, lethargy, difficulty passing stools. Non-specific diffuse mass felt in the lower abdomen. Abdomen is somewhat tender to palpation. Rectal exam yields soft yellow stools.
What is the embryology of Hirschprung disease?
absence of autonomic ganglion cells in the distal myenteric plexus
How do you initially manage Hirschprung disease?
Stop feeds, decompress stomach, start broad spectrum antibiotics
What is the definitive therapy for Hirschprung disease?
surgical exploration and repair
8 mo M
Lethargy, vomiting and irritability. 2 days of intermittent vomitting and pain. Spasms last between 5 and 10 mins. Bile in vomit. Abdomen is moderately distended and tender to palpation. Currant jelly stool.
How do you treat intussusception?
What anomaly might be present w/ intussusception?
What is the embryology associated with intussusception?
ileal outpouching that often contains gastric or pancreatic tissue
Pregnancy complicated by size greater than dates. Large quantity of amniotic fluid was expelled. Baby developed respiratory distress which improved w/ suctioning of pharynx. Distended epigastrium, decreased bowel sounds and low tone.
What is the embryology of duodenal atresia?
Failure of reformation of hte duodenal lumen
What global diagnosis fits w/ duodenal atresia?
Down syndrome = size greater than dates, flat occiput, extra nuchal skin, almond shaped eyes
What other tests would be useful in a pt with duodenal atresia?
Chromosome analysis for aneuploidy
CBC w/ peripheral smear