OnlineMedEd: Pediatrics - "Baby Emesis" Flashcards
Give the characteristics of normal vomiting in an infant.
- Occurs after feeding
- Formula-colored (i.e., non-bloody, non-bilious)
- Non-projectile
Projectile vomiting – regardless of color –indicates _____________.
some type of obstruction
What features of the history can help you distinguish malrotation from duodenal atresia?
• Malrotation:
- Normal pregnancy (i.e., no polyhydramnios)
- Normal baby (i.e., no Down syndrome)
•Duodenal atresia:
- Abnormal pregnancy (i.e., polyhydramnios)
- Syndromic baby
True or false: the double-bubble sign indicates duodenal atresia.
True, but it can also be a sign of malrotation (particularly if there is a normal gas pattern in the intestines).
What’s the difference between a malrotation and a volvulus?
Volvulus is a malrotation with ischemia.
Duodenal atresia results from ______________.
failure to recannalize
Duodenal atresia is almost indistinguishable –in the history and the exam/imaging –from _____________.
annular pancreas: both present with first-day biliary emesis, the double-bubble on x-ray with no gas beyond, polyhydramnios in pregnancy, and a predilection for it in those with Down syndrome
How can you differentiate intestinal atresia from other neonatal obstructive bowel diseases?
Intestinal atresia results from vasospasm, so maternal use of vasoconstrictors can increase the risk of it. Also, because it happens later in the disease course, polyhydramnios may not be present.
The “classic” diagnostic for esophageal fistula is ________________.
an NG tube that coils on x-ray
______________ is caused by hypertrophy.
Pyloric stenosis
Visible peristaltic waves are suggestive of ___________.
pyloric stenosis
How should you treat pyloric stenosis?
myotomy of the pylorus (and also make sure the baby is not toxic from vomiting with a good PE and CMP)
