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SURGERY

Pedi

QuestionAnswer
Sudden onset of bilious vomiting in newborn; presents within 1yr. What is the diagnosis, what tools to diagnose, what is the initial tx? Malrotation of Gut, UGI to visualize malpositioned ligament of Treitz, Emergent laparotomy & Ladd’s procedure (rotate counterclockwise) w. resection of dead bowel
Usually in males, presents as failure to pass meconium in 1st 24hr; abd distention, bilious vomiting; may present later w. constipation, diarrhea, slowed growth. What is the diagnosis, what tools to diagnose, what is the initial tx? Hirschsprung’s Dz; AXR (dilated colon), unprepared barium enema, rectal biopsy; Colostomy proximal to transition zone, or resection & pull-through anastomosis
Most in 1st born males 2 wks to 2 mos old; inc regurgitation then nonbilious projectile vomiting; dec wt, dec stool, epigastric mass (“olive”). What is the diagnosis, what tools to diagnose, what is the initial tx? Pyloric Stenosis; H&P; U/S, barium swallow (string sign); Hydration, correction of lytes & acid-base disorder, Fredet-Ramstedt pyloromyotomy
Bowel obstruction in 2mos to 2yr- old; preceded by viral infxn; sudden onset of recurring severe crampy abd pain, vomiting, drawing up legs, currant jelly stool; RUQ mass, empty RLQ-Dance’s Sx. diagnosis, what tools to diagnose, what is the initial tx? Intussusception; Air or barium enema: coiled spring appearance; Hydrostatic reduction during air enema; surgical exploration if unsuccessful or if peritonitis; manual reduction; resection
Painless bleeding, obstruction; usually within 2 yrs & in males; What is the diagnosis, what tools to diagnose, what is the initial tx? Meckel’s Diverticulitis; Technetium- pertchnate scan if gastric mucosa; Wedge resection or segmental ileal resection; do w. appendectomy
Cigarette burns, rope burns, scald to posterior thighs/buttocks, multiple or old Fx, genital trauma, delayed access to health care. What is the diagnosis, what tools to diagnose, what is the initial tx? Child Abuse; admit child to hospital.
Created by: christinapham