Paeds & Congenital Flashcards
Causes of bowel obstruction in an older child?
AA-II-MM
Appendicitis
Adhesions
Inguinal hernia
Intussusception
Midgut volvulus
Meckel’s diverticulum
On hepatoblastoma:
“the commonest primary liver tumour in children”
- Associations?
- Presentation?
- Appearance on CT/MR?
- Two key points to check?
- BWS, hemihypertrophy, prematurity, and many others…
- Abdominal mass/distension + raised AFP
- Well-defined, heterogenous, mainly low attenuation mass; often coarse calcification; may be haemorrhage and rim enhancement
- Is it multifocal? Is there vascular invasion?
On left-sided isomerism:
“aka polysplenia”
- Most common features?
- Cardiac defects?
- Other features?
- Abnormal spleen, abnormal IVC - interrupted with continuation of azygous or hemiazygous
- Less than in right-sided isomerism. ASD much more common
- Bowel malrotation; truncated pancreas; biliary atresia
On right-sided isomerism:
“aka asplenia”
- Most common features?
- Other features?
- Asplenia, severe cyanotic heart disease (TAPVR)
- Bowel malrotation; horseshoe kidney
Liver mass in <3, with raised AFP and possible precocious puberty, coarse calcifications and vascular invasion?
Hepatoblastoma
Liver mass in <3 with raised EGF, low platelets and signs of congestive cardiac failure?
Haemangioendothelioma
Liver mass in <3 which is cystic, AFP negative and lacks calcifications?
Mesenchymal hamartoma
T1 - variable due to cyst content
T2 - hyperintense
T1 +c - septae and stromal components can enhance
Solid renal mass in <1, hypoechoic on US with involvement of sinus fat but no herniation into renal pelvis and hypoenhancement on CT?
Mesoblastic nephroma
“Most common solid renal tumour of infancy”
May have cystic spaces
Cystic renal mass in neonate with no functioning renal tissue?
Multicystic dysplastic kidney
Nephroblastomatosis
- on US
- on CT
- small nodules of varying echogenicity, may be enlarged kidneys if diffuse
- peripheral parenchymal nodules that enhance less than adjacent tissue; if diffuse, homogenous peripheral low attenuation that forms a “rind” around the kidney
Differential diagnosis for lucent metaphyseal bands?
Leukaemia
Infection (TORCH)
Neuroblastoma mets
Scurvy
Rickets
What kind of ASD is seen in Down’s syndrome?
Ostium primum ASD (part of spectrum of endocardial cushion defects)
Which kind of ASD has the better prognosis?
Ostium secundum - may close on its own, less symptomatic
Bone marrow transplant complications of the early pre-engraftment period (15-30 days) and early post-engraftment period (100 days)?
Interstitial pneumonitis
- infective CMV
Infection - fungi, Klebsiella
Haemorrhage
Oedema
PE
Calcifications
BOOP/COP
Bone marrow transplant complications of the late post-engraftment period?
Chronic GVHD
Bronchiolitis obliterans
Infection
Lymphoid interstitial pneumonia
Fibrosis
