Paeds: GI Flashcards
Causes of bilious vomiting
Volvulus
Intestinal malrotation
Duodenal atresia
Necrotising enterocolitis
Management of constiptaion in kids
- Osmotic laxative
- Movicol (polyethelyne glycol 3350 + electrolytes) - Stimulant laxative
Months of change in bowel habit
“Peas and carrots” in stool
Toddler’s diarrhoea
- self resolves
- introduce more fat as that increases digestion time
Bilious vomiting
Bloody stool
Abdominal distension
Necrotising Enterocolitis
caused by:
E.coli
Klebsiella
Enterobacter
XR: Penumatosis intestinalis
- gas cysts in bowel wall
Dilated bowel loops (asymmetrical)
Bowel wall oedema
Portal venous gasNecrotising Enterocolitis
- stool culture useful
Causes of necrotising enterocolitis
E.coli
Klebsiella
Enterobacter
Risk factors of Necrotising enterocolitis
Formula feed
IUGR
Umbilical artery insertion
Prematurity
Management for necrotising enterocolitis
Stop oral feeds (rest gut)
Vancomycin + cefotaxime
Laparotomy
Bilious vomiting first few days of life
High volume vomits
No abdo distention
Duodenal atresia
- associated with downs syndrome
XR: Double bubble sign
Duodenal atresia
Bilious vomiting in newborn
Sucked in abdo (scaphoid abdomen)
High caecum at the midline
Intestinal malrotation
- associated with exomphalos, diaphragmatic hernia + duodenal atresia
- can occur with volvulus
Investigations for intestinal malrotation
Upper GI contrast study
USS
Management of Intestinal malrotation
Laparotomy
Ladd’s procedure if with volvulus
Non bilious vomiting
Projectile vomiting for first few weeks of life
Constipation + dehydration
Palpable mass in upper abdomen
Pyloric stenosis
hypertrophy of circular muscles of the pylorus
4M:1f
10% = FHx
Investigations for Pyloric stenosis
US
Decreased potassium: due to vomiting
Decreases Cl
