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35 Cards in this Set
- Front
- Back
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high vs low intestinal obx
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high obx is above distal jejunum
low is below jejunum |
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pathophys of small bowel atresia
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bowel is solid tube that recanalizes btwn 3-6 wks; in atresia, the canalization fails to occur
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where in duodenum does bowel atresia usually occur; assoc w?
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80% are above ampulla of Vater; often associated with bile duct/pancreatic abn
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if you see a dbl bubble,why is it not caused by midgut volvulus
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Midgut volvulus is acute and wouldn't cause dilatation of duo bulb so quickly
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duodenal web?
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obstructing membrane in the normally hollow duodenum, but not quite atresia, sometimes liquids are able to pass
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FLX finding of duodenal web
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Wind-sock deformity
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When do duodenal webs present
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later in life, b/c often they are able to drink without dificulty.
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pathophys of small L colon syndrome
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fxnal immaturity of ganglion cells
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Etiologies of small L colon syndrome
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maternal DM
MgSO4 |
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T or F:
There is a relationship btwn meconium plug syndrome and CF |
false
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where does meconium ileus occur
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distal ileum (no succus enters colon)
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way to differentiate meconium plug from hirschsprung
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If pt stools after enema, then likely meconium plug
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Entities assocaited with Hirschsprungs
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Down's
congenital Nb |
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Findings associated w meconium peritonitis
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Bowel obx
peritoneal calcs meconium cysts |
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Classic finding o fHirschsprung on BE
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sigmoid:rectum >2:1
occassionally, saw-toothing of affected segment |
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3 types of intussusception
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idiopathic idiocolic - 2/2 lymphoid hyperplasia in TI from viral infx (usually 3m - 1yr old)
pathologic >3 yo (Sb-SB most commonly from carcinoid, colon CA, and lymphoma) incidental (small bowel-small bowel) |
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where is abn usually in early NEC
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RLQ
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signs to look for in NEC
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focal ileus
BG pattern that hasn't changed over time portal venous gas pneumoatosis FA |
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On XR, how to determine if there is TE fistula vs esoph atresia
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in TE fistula, you often have air distally
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Abn associated with esoph atresia
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VACTERL
Vertebral anom Anal atresia Cardiac anomalies TE fistula Renal anomalies Limb anomalies |
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pathophys of malrotation
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Duodenum rotates by making 3 90 degree turns at 4-6 wks GA. Duo-jej is fixed by lig of Treitz; mesentary for SB has a long base that prevents SB from twisting. If DJJ and ileocecal jxns are not in nml position, they can twist --> volvulus
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Define midgut volvulus
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Abn twisting of SB around axis of SMA --> obx, ischemia, infarct
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Which part of SB are retro and intraperitoneal
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Duo bulb is intra but distally becomes retro
jejunum becomes intra (@ lig of Treitz) |
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what are ladd bands
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Abn fibrous peritoneal bands taht are seen in malro --> obx and volvulus
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approach to distal bowel obx dx in baby
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No microcolon
1. small L colon syndrome 2. meconium plug 3. nml variant 4. Hirschsprung microcolon (small from disuse, no succus passes through) 1. ileal atresia 2. meconium ileus |
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Pathophys of meconium ileus
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OBx of distal ileum 2/2 especially tenacious meconium
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Complications of meconium ileus
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perf, volvulus, meconium peritonitis
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XR findings to suggest intussusception
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Paucity of bowel gas in right abd
abscence of air-filled cecum or asc colon can have NML xr |
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DDx decreased hepatic uptake in HIDA scan in neonate
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neonatal hepatitis
hepatic necrosis cirrhosis |
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etiology of colonic atresia
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vascular injury
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appearance of choledochal cyst
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cystic mass in region of porta hepatis
(will see CBD/CHD directly emptying into cystic mass) |
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where do GI duplication cysts usually occur
do they communicate |
TI and distal esoph (do NOT usually communicate wtih GIT)
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how does infantile hemangioendothelioma present
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high output CHF and abd mass
may have low plts |
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Course of infantile hemangioendothelioma
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spont involute
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appearance of hepatoblastoma
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well defined mass arising from liver --> displacement of structures
+/- necrosis/hemorrhage |
