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Flashcards in Surgery Deck (31):
1

6 weeks old with projectile vomiting

pyloric stenosis

2

what causes the lumps on the abdomen in pyloric stenosis

normal peristalsis waves pushing against the pylorus

3

why do you get pyloric stenosis at 6 weeks

pylorus muscle thickens and causes a physical obstruction to the milk being taken in

4

what is the treatment for a pyloric stenosis

pyloromyotomy - cutting the muscle of the pylorus (care taken not to breach the mucosa underneath)

5

what is this presentation: 6 months vomiting food then yellow and then green. sausage like mass in the abdomen . blood (red current jelly) in nappy

intussusception

6

what is intussusception

where bowel acts like a telescope- folds in on itself

7

what signs suggest intussusception

target sign- looks like a bullseye on ultrasound

pseudo kidney- from opposite view looks like a kidney

8

what is the treatment for intussusception

radiology push air into colon to blow out the folds- works in 70-80% of cases, if not need surgery

need to be fully resuscitated before this happens- can loose fluids as cant take any in

9

what is this presentation: 6 years old, stomach pain, painful during bumps in the car, cant jump, mild temperature

appendicitis
unable to jump means they have peritonitis

10

what investigations into appendicitis

ultrasound

11

what is the treatment for appendicitis

appendectomy- 95% laparoscopic

12

what is this presentation: baby vomiting green

EMERGENCY MIGHT BE MALROTATION WITH VOLVULUS

13

what colour vomit in volvulus, why

green- fairly liquid

due to bile and pancreatic juice

14

what happens in malrotation

fixed points in abdomen (jejunum and cecum) form the longest line in the abdomen- path of the superior mesentic artery

if this points fixed in wrong place then unstable and can bowels can twist causing a vulvulus

15

how do you tell if its a vulvulus

contrast scan

16

what does a blue/ black scrotum suggest

torsion, testicles have died

17

what can cause the scrotum to be inflamed

infection

18

what can cause a blue/ black dot on testicles

torted hydatid

19

what is a hydatid

embryological remnant of the ovarian duct

20

what cause inflammation on scrotum that goes down to perineum and up into groin

idiopathic scrotal oedema - cures itself

21

what is Balanitis Xerotica Obliterans (BXO)

when penile head is scarred, white or fissured

22

what can help loosen foreskin

steroid cream

23

what is hypospadias

congenital problem where the opening of the urethra is on the underside of the penis

24

can you differentiate a hydrocele and a hernia in testes via transillumination

no will both glow

25

what is orchidopexy

surgery to move an un-descended testicle into the scrotum

26

why are un-descended testes operated on

as might form tumour, unexaminable in groin. no difference for fertility. improved cosmesis

27

what should be seen in inguinal canal in laproscopy

testicular artery and vas deferens meeting at (closed) deep ring if normal

if no testicle then arteries will be spidery

28

what does the testicular artery come off

aorta

29

why might the deep ring be open

no testicle or undescended

30

what can get trapped in the deep ring

bowel- hernias

31

how do you operate to descend testicles

cut blood supply from testicular artery so that blood supply from below strengthens - some testicles will be lost

then relocate to scrotum