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Peds - GI system

test 2

Gi disorders can result from: congenital defect; acquired disease; infection; injury; motility issues; inflammation; malabsorption.
Colic incessant crying for >3 hours/day, > 3 days a week, for >3 weeks. starts before 3mo old. not sure of the cause.
what can be done to help Colic? change to soy formula. check mother's diet (she make need to change it). rocking. swaddling. mylicon drops (can help with gas).
REST Regulation. Entertainment. Structure. Touch.
Cleft Lip incomplete coming together of the maxillary and nasal tissues. multifactorial. multiple congenital anomaly syndromes. may/may not have cleft palate as well. unilateral or bilateral. incomplete or complete.
Cleft Lip: When does repair happen? ~10 weeks to 6 months of age. at least 10lbs. Hgb 10.
Cleft Palate incomplete coming together of the palatae. may be incomplete (soft palate only) or complete (hard and soft palate). unilateral or bilateral. multifactorial.
Cleft Palate: when does repair happen? 6-18 months
GERD transient relaxation of the esophageal sphincter which allows stomach acids to come up into the esophagus.
GERD baby not happy, poor weight gain, passive regurgitation, arching/pulling away with feedings.
GERD old child aspiration pneumonia. usually developmentally delayed. will need surgery.
Laproscopic Nissen Fundoplication top part of the stomach is wrapped around the intra-abdominal esophagus.
pyloric stenosis thickening of the muscle of the pylorus. food is not able to leave the stomach.
pyloric stenosi: common sx projectile vomiting. palpable olive-like mass mid-epigastrium. weight loss. dehydration.
pyloric stenosis: Dx hx & abdominal ultrasound
pyloric stenosis: Tx stabilize (not rush to surgery right away. child will be very sick). pyloromyotomy (slicing the pyloric muscle).
Appendicitis inflammation of the appendix. acute obstruction of the lumen of the appendix. increased pressure in the appendix (bacteria/pus). ischemia, cell death, eventual rupture of appendix.
Appendicitis: what does this child look like? generalized abd pain. colicy, crampy, nausea, vomiting. may be mis-dx as gastroenteritis. focal pain in RLQ at McBurney's point. rebound tenderness. mid temp 100.5-102. elevated WBC, + ultrasound, - pregnancy test.
appendicitis: surgery laproscopic appendectomy
Appendicitis: Tx (not ruptured) take out the appendix, go home.
Appendicitis: Tx (rupture discovered in OR). JUST reuptured. penrose drain so all the crud can drain out. let surgeon change first dressing so they can see the drainage.
Appendicitis: Tx (rupture discovered before OR). surgery will be delayed. NPO. triple abx (IV then oral). possible TBP & lipids. surgery in weeks to 2 months.
intussesception telescoping of intestine into adjacent distal intestine. mesentary (blood supply) is pulled through the bowel. compression/obstruction of lymph & blood flow. pressure builds. eventually arterial blood flow stops. ischemia, perforation, peritonitis.
Intussesception: what does it look like? screeming in pain alternating with periods of calm. currant-jelly stools. sausage-like mass RLQ. absent bowel sounds RLQ. may resolve without intervention.
Intussescaption: Dx ultrasound. water-soluble contrast enema (treatment as well). may need surgery to manually reduce telescoping. end-to-end anastomosis of dead bowel.
Hirshprung's Disease AKA congenital aganglionosis of the colon. part of the nerve fibers (ganglion) of the colon responsible for peristalsis are absent. extent of missing ganglion varies. dx by rectal biopsy.
Hirshprung's Disease: newborn no meconium. may be very sick. rectal biopsy. surgical repair or temporary colostomy w/ end-to-end anastomosis when older.
Created by: malysab14