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14 Cards in this Set
- Front
- Back
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Normal gastrointestinal embryology |
1- Foregut 1- Esophagus to duodenum at the level of the pancreatic duct and common bile duct (Ampulla of cater) 2- Midgut - Lower duodenum to proximal 2/3 of transverse colon 3- Hindgut - Distal 1/3 of transverse colon to anal canal above pectinate line |
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Midgut development |
1- 6th week - Physiological hernia took of midgut through umbilical ring 2- 10th week - Returngzhfjf to abdominal cavity and rotate around superior mesenteric artery (SMA) 2- Total 270• counterclockwise |
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Ventral wall defect |
Developmental defect due to failure of rostal fold closure (eg sternal defects (ectopic cordis) lateral fold closure (Omphalocele, gastroschisis) and caudal fold closure (eg bladder e trophy) |
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Gastroschisis |
1- Extrusion of abdominal contents through abdominal fold (right of umbilicus) 2- Not covered by peritoneum or amnion 3- Not associated with congenital anomalies, favorable prognosis |
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Omphalocele |
1- Failure of lateral wall to migrate at umbilical ring- persistent midline herniation of abdominal content into umbilical cord 2- Surrounded by peritoneum 3- Associated with congenital anomalies (trisomy 13, 18 and Beckwith- Wiedmann syndrome) and structural abnormalities (cardiac, GU and neural tube) |
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Congenital umbilical hernia |
1- Failure of closure of umbilical ring after physiology herniation of the midgut 2- Small defects close spontaneously |
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What congenital disorders are associated with a congenital umbilical hernia |
Down syndrome Congenital hypothyroidism |
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Tracheoesophageal anamolies |
1- Esophalgeal atresia (EA) with distal treacheoesophageal fistual (TEF) most common 85% often present with polyhydromnios in utero (due to inability of fetus to swallow amniotic fluid) 2- Features 1- Neonate drool choke or vomit with fist feed 3- TEF allows air to enter stomach (visible on CXR) - burning with vomit 4- Cyanosis 2’ to laryngospasms (to avoid reflux related aspiration) 5- Clinical test 1- Failure to pass NGT 6- In H type (pure TEF), fistual resemble the letter H 7- In pure EA, CXR shoe gassless abdomen |
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Intestinal atresia |
1- Present with bilious vomiting and abdominal distention with 1-2 days of life 2- Duodenal atresia 1- Failure to recanalize 2- Abdominal X ray shows double bubble sign (dilated stomach and proximal duodenum) 2- Associated with Down’s syndrome 3- Jejunal and ileal atresia 1- Disruption of mesenteric vessels (SMA) 2- Ischemic necrosis of fetal intention— segmental resorption- bowl become discontinuous 3- X ray dilated loops of small bowel with air fluid levels (Triple bubble) |
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Hypertrophic pyloric stenosis |
1- Most common cause of gastric outlet obstruction in infants (1:600) 2- Features 1- Palpable olive shaped mass in epigastric region 2- Visible peristalsis wave 3- Non- bilious projectile vomiting at 2-6 weeks old 3- More common in first born males, associated with exposure to macrolide 4- Results in hypokalmeic hypochloremic metabolic alkalosis (2’ to vomiting gastric acid and volume contraction) 5- U/S - thicken and lengthen pylorus 6- Treatment 1- Surgical resection of pylorus muscle ( pylorumyotomy) |
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Pancreases embryology |
1- Derived from foregut 2- Ventral pancreatic bud contributes to uncinate process and main pancreatic duct 3- Dorsal pancreatic bud contributes to body, tail, isthmus and accessory pancreatic duct 4- Both the ventral and dorsal pancreatic bud contributes to the head |
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Annular pancreas |
1- Abnormal rotation of the ventral pancreatic but form a ring of pancreatic tissue 2- Encircles the 2nd part of the duodenum 3- May cause duodenal narrow and vomiting |
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Pancreases divisum |
1- Failure of the ventral and dorsal pancreatic bud to fuse at 8 weeks 2- Common anomaly 3- Asymptomatic but can cause chronic abdominal pain and/pancreatitis |
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Spleen embryology |
1- Arises in mesentery of the stomach (hence is mesodermal) 2- Foregut blood supply (celiac trunk- splenic artery) |
