Musckovitz: GI Developmental Cases Flashcards Preview

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Flashcards in Musckovitz: GI Developmental Cases Deck (18):
1

3 week infant w/ projectile vomiting immediately after fed that looks like breast milk. Mobile mass mid xiphoid. Jaundiced.

Congenital hypertrophic pyloric stenosis

2

What causes congenital hypertrophic pyloric stenosis?

hypertrophy of the muscles at the distal end of hte stomach

3

How do you treat congenital hypertrophic pyloric stenosis?

Normalize electrolytes

Call a surgeon to perform the Ramstedt procedure

4

Why is a baby w/ congenital hypertrophic pyloric stenosis jaundiced?

Starvation increases the enterohepatic recirculation of bilirubin

5

What are the RFs for congenital hypertrophic pyloric stenosis?

First born M

SE of erythromycin in infants

6

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.

Hirschsprung disease

7

What is the embryology of Hirschprung disease?

absence of autonomic ganglion cells in the distal myenteric plexus

8

How do you initially manage Hirschprung disease?

Stop feeds, decompress stomach, start broad spectrum antibiotics

9

What is the definitive therapy for Hirschprung disease?

surgical exploration and repair

10

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.

Intussusception

11

How do you treat intussusception?

Barium enema
Surgical consult

12

What anomaly might be present w/ intussusception?

Meckel diverticulum

13

What is the embryology associated with intussusception?

ileal outpouching that often contains gastric or pancreatic tissue

14

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.

Duodenal atresia

15

What is the embryology of duodenal atresia?

Failure of reformation of hte duodenal lumen

16

What global diagnosis fits w/ duodenal atresia?

Down syndrome = size greater than dates, flat occiput, extra nuchal skin, almond shaped eyes

17

What other tests would be useful in a pt with duodenal atresia?

Chromosome analysis for aneuploidy
Cardiac echo
CBC w/ peripheral smear

18

Most infants w/ Down syndrome are born to young or old women?

young