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11 Cards in this Set
- Front
- Back
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What are some differences in the approach between peds and adult gastroenterology?
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they speak through parents
congenital anomalies are more common, cancer (esophageal, gastric, colon) is very rare. infectious and systemic conditions (acidosis, metabolic problems) often present with GI symptoms dietary intolerance is common invasive procedures are physically and emotionally difficult |
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What's the differential diagnosis for chronic (>3wks) vomiting in infants?
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infection (otitis media, meningitis, UTI)
anatomic (congenital anomaly, volvulus, inguinal hernia) mucosal injury (GER, peptic ulcer, allergic gastoenteritis) GI motility (Hirschsprung, pseudoobstruction) visceral GI disorder (choledochal cyst) endocrine/metabolic (adrenal hyperplasia, organic acidemias, FA oxidation problems, amino acidemias, uria cycle defects, mitochondriapathies) neuro (hydrocephalus, subdural hematoma, intracranial neoplasm) other: overfeeding, toxic ingestion, rumination, Munchausen by proxy |
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How does GER present in infants?
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nonbiliary, non projectile emesis, GI bleeding, poor growth, irritability
found in 80% of normal newborns, 20% need medical help (positioning, surgery, H2AR)-- usually resolves by 2 yo. |
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How do you diagnose GER in an infant?
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history, UGI, nuclear medicine scintiscan (milk-scan), 24 hour pH probe, endoscopy
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How does allergic gastroenteritis present in an infant?
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this includes eosinophilic esophagitis and eosinophilic gastritis.
chrnoic vomiting, failure to thrive, feeding disorders, usually due to cow's milk or soymilk protein |
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How do you diagnose and treat allergic gastroenteritis in an infant?
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history (part of atopic family), allergy testing, endoscopy.
tx: dietary, sometimes meds |
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What's esophagial atresia, how does it present, and how is it diagnosed?
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a congenital anomaly, usually a tracheoesophageal fistula (most common: blind esophagus with a distal tracheoesophageal fistula)
presentation: emesis, aspiration. immediate. H-type shows up later. dx: 50% had polyhydramnios, clinically, x-ray. tx: surgery |
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What's pyloric stenosis, how does it present, and how is it diagnosed?
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congenital anomaly with idiopathic hypertrophy of the pyloric muscle, 5 boys: 1 girl
presentation: nonbilious projectile vomiting at 3-6 wks, poor weight gain, dehydration (**hypochloremic acidosis), "olive" can sometimes be palpated. dx: pyloric sonogram, UGI tx: surgical |
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What's duodenal atresia, how does it present, and how is it diagnosed?
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1/10,000, 50% premies, 20-30% Down's. atresia, stenosis, or annular pancreas.
presentation: emesis at 2 days old, bilious or nonbilious (relative to ampulla of Vater), poorly tolerated feedings, may have abdominal distention. dx: abd flat plate (double bubble), UGI tx: surgical |
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What's malrotation, how does it present, and how is it diagnosed?
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congential anomaly in 0.2% of population. A problem with rotation causes inappropriate fixation, causing problems with volvulus or compression.
volvulus --> vilious emesis and pain, bowel ischemia/necrosis, vomiting and distention. Ladd's bands --> compression by misplaced connective tissue --> vomiting and distention. dx: UGI, barium enema tx: surgical |
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What's an intestinal atresia, how does it present, and how is it diagnosed?
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congenital complete obstruction of jejunum and ileum. usually idiopathic but may stem from ischemic events.
presentation: bilious emesis, growth failure, abdominal distention dx: radiological studies tx: surgical |
