Paediatric GI/ Surgery Flashcards
(32 cards)
What are the typical blood gas findings for a baby with pyloric stenosis?
Hypochloraemic hypokalaemic metabolic alkalosis with base excess
What does a double bubble appearance on X-Ray indicate?
Duodenal atresia
What is the gold standard investigation for developmental dysplasia of the hip?
USS
Wilm’s tumour is associated with defects on which chromsome?
11
How does the presentation of Ig-E mediated cows milk protein allergy compare to non-IgE cows milk protein allergy?
IgE mediated: acute onset, more allergic symptoms e.g. urticaria, angio-oedema, sneezing, conjunctivitis as well as colicky abdo pain, vomiting and diarrhoea
Non-IgE mediated: slower onset, more GI symptoms e.g. diarrhoea, blood/ mucus in stool, colic, perinatal redness, constipation
How is cows milk protein allergy managed?
Elimination of cows milk from diet for minimum 6/12, including mums diet if breastfeeding
If formula fed:
1st line: extensively hydrolysed formula
2nd line: amino acid formula
Reintroduce cows milk every 6-12 months to assess tolerance, 90% Sr fine by 3y/o
When does pyloric stenosis usually present?
2-8 weeks (pyloric typically normal at birth, then will hypertrophy)
What is the name of the surgery to treat pyloric stenosis?
Ramstedt’s pylorotomy
Divides the hypertrophied pylorus
How can pyloric stenosis present?
Projectile non-bilious vomiting Weight loss Dehydration Constipation Mass in RUQ with peristaltic waves visible Palpable pylorus during feed
Where does intussusception usually occur?
Terminal ileum into caecum
In what age does intussuscpetion usually present?
2 months to 2 years old
What is the typical presentation of intussusception?
Vomiting, abdominal distension, sever colicky abdominal pain
Red current jelly stools
Target sign on an abdominal USS is suggestive of what?
Intussusception
How is intussusception managed?
Air enema to force back the intussuscepting bowel
Fluid
IV abx (possibility of sepsis)
Surgery if perforation/ peritonitis
For undesceded testes, when is orchidoplexy performed?
Age 6-18 months
How may necrotising enterocolitis present?
Poor feeding, bilious vomiting, distended abdomen, bloody stool
How is necrotising enterocolitis treated?
Bowel rest NBM, TPN feeds NG tube to decompress IV fluid IV Abx Surgery if deteriorating or perforation Restarts oral feed 7-10 days after gas in bowel disappears
When would you refer to a paediatric surgeon for undescended testes?
If not descended by 6 months
What is the treatment for Hirschsprung’s disease?
Rectal washouts initially
Surgical anorectal pullthrough procedure
Kasai procedure is the surgery for which condition?
Biliary atresia
Ground glass appearance on x Ray is seen in which condition?
Respiratory distress syndrome
What is looked at in the coeliac screen?
IgA immunoglobulin
tTGA (tissue transglutaminase antibody)
EMA (endomysial antibody)
What will an upper GI biopsy show if positive for coeliac screen?
Crypt hyperplasia
Villus atrophy
Lymphocytosis
Henoch Schonlein purpura classically presents with what symptoms?
Purpuric rash (buttocks and legs)
Haematuria (Proteinuria)
GI symptoms/ abdominal pain
Arthralgia
