Surgical Problems of Neonates Flashcards
what is portal gas on an x ray
when gas gets into portal tracts of liver and extends up into liver
what causes nectrotising enterocolitis (NEC)
usually in premature babies mucosa of bowel breaks down due to bacteria
causes inflammation, ischaemia, necorsis and perforation of the bowel
what is the presentation of NEC
non specific:
- poor feeding
- bile stained vomit
- abdo distention
- blood stained stools +/- explosive diarrhoea
- resp distress with acidosis
- sepsis
what are the three types of cause of obstruction
something in lumen
something wrong with lumen integrity
something outside lumen
what is the presentation of a meconium ileus
baby keen to feed
vomiting at 48hrs (may be green)
havent pooed
abdo distention and feels doughy on palpation
what causes a meconium ileus
cystic fibrosis- poo sticky and cant come out
what is the Tx for a meconium ileus
fluoroscopy to Ix
laparotomy and possibly a stoma
what colour is a babies first poo normally
black
is it normal for a baby not to have done a poo by 48 hours
no- get surgeon
what is an atresia
dead end in GI tract, anywhere from mouth to anus (usually in small bowel)
what is the presentation of a jejunal atresia
baby looks normal feeds at birth at 6 hours baby vomits up green stuff (time of presentation will depend on how high or low the atresia is) abdomen looks full wont have done poo
what Ix for atresia
plain X ray:
- very distended bowel
- not many loops of bowel (+ short time to presentation) = high blockage
what is the presentation of an inguinal hernia
swelling in inguinal area that extends into scrotum
may have asymmetrical creases at hips/ belly
can present acutely if gets strangulated
why are belly creases important in hernias
where incision is made so as to hide scar
what does laddering of bowel on X ray suggest
(layering of loops of bowel on top of each other)
obstruction
