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82 Cards in this Set
- Front
- Back
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What is the normal diameter of the bowel loops |
diameter of the vetebrae at t12
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Can you tell the type of bowel based off of postion ino the abdomen
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no, not like adults
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What is the cause of NEC
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idiopathic
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What is the mortality of NEC
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30%
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What is the cause of NEC
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unknown, but hypoxia, infection are suspect
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Where is the MC location of NEC
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RLQ
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Is NEC patchy
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yes
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What are the SS of NEC |
abdominal distension, feeding intolerance, vomitting, blood in stool and diarrhea, lethary,
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What are some radiographic signs of NEC 3
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distendend bowel loops (MC)
pneumotosis (later finding) PV gas pneumoperitoneum |
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What causes of abdominal wall defects
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- cephalic fold defect
-lateral fold defect -caudal fold defect |
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What is the result of a cephalic fold defect
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pentalogy of cantrell
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What are the findings in pentalogy of cantrell
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CHD
ventral hernia sternal defect absent anterior diaphragm pericardial defect |
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What type of fold defect causes omphalocele and gastroschisis
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lateral
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What is the result of a caudal fold defect
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cloacal extrophy
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What is cloacal extrophy
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ophalocele, epispadias, and bladder extrophy
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Name 4 characteristics of an omphalocele
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midline
covered by peritoneum cord inserts in to apex 2/3 have additional abnormalities |
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What is the MC location of a gastroschisis
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right side
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What is the suspected cause of gastroschisis
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vascular insult
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Are anomalies frequently assoicated with gastroschisis
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no
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What are 4 characteristics of gastroschisis
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right sided
infrequent anomalies bowel herniation no peritoneal covering |
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What is a common complication of gastroschisis
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bowel shortening and atresia from exposure to amniotic fluid
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What should be suspected if there is polyhydramnios
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obstruction to fetal swallowing (esophageal atresia/trachoesophageal fistula)
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What % of patients with esophageal atresia TEF have associated anomalies
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50%
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What is the syndrome associated with EA
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VACTERL
vetebral anomalie anal atresia cardiac TEF or EA renal limb (also hip dislocation) |
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What do you suspect if there is no bowel gas
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EA without TEF
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What particular group has a higher incidence of EA without TEF
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downs
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What is an N type fistula
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patency between esophagus and trachea during swallowing (this is very rare)
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What is considered a high bowel obstruction
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above the jejunum
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What is considered a low bowel obstruction
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below the jejunum
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What are the causes of a proximal obstruction in a neonate
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gastric atresia or web
pyloric stenosis doudenal atresia, stenosis or web doudenal duplication cyst malrotation midgut volvulus jejunal atresia and stenosis |
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What is the cause of doudenal atresia
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failure of the doudenum to recanalize at 3-6 wks gestation
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Where do 80% of doudenal atresia occur
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distal to ampulla of vater
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What is a common association with doudenal atresia
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annular pancreas or predoudenal portal vein
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What is the MC assoication with doudenal atresia
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downs
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What are 4 associated findings with doudenal atresia patients
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other intestinal atresia
CHD downs vaterl |
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When do you see the double bubble
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doudenal atresia
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What is more common in downs; web or atresia
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web
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Explain the normal bowel rotation
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returns from the yolk sac at 3-10 wks gestation
3 counter clockwise 90 degree turns results in normal rotation. |
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What are 3 things to look for if you want to rule out malrotation
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the SB goes to the left side
jejunum is on the left cecum is in the RLQ |
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What is a common complication of malrotation
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midgut volvulus
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Why does malrotation occur
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there is a short mesentery which is prone to twisting
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When do 75% of midgut volvulus present
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first 6 wks of life
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What is the hallmark of midgut volvulus
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bilious vomitting
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What is used for diagnosis of midgut volvulus
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upper gi
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What finding do you expect fo have on UGI in a patient with midgut volvulus
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corkscrew
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how do differentiate proximal vs distal bowel in children
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a few loops vs a lot of loops (in children location of bowel can be misleading)
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What are 7 causes of a distal bowel obstruction in a neonate
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ileal atresia
meconium ileus colonic atresia small left colon meconium plug hirschsprung imperforate anus |
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What is the study of choice for distal bowel obstruction in the neonate
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contrast enema
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What are you trying to determine with an enema
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if there is a microcolon (if so it means there is a high grade ileal obstruction)
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Do almost all patients with CF present with meconium ileus
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no 5-10% but all pt with meconium ileus have CF
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What are the complications of meconium ileus
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perforation, volvulus
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Can an enema be theraupeutic for meconium ileus
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yes and it may take a couple times
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How to you tell where a colonic atresia is located
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enema (the contrast will stop at the level of atresia)
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Are colonic atresias frequently multiple
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yes
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What demographic typical results in functional immaturity of the colon
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diabetic mothers
mothers on magneusium |
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What is functional immaturity of the colon
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Distal colon spastic and narrowed, causes functional obstruction usually at splenic flexure
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What are the 2 subgroups of functional immaturity of the colon
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small left colon
meconium plug |
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What typically mimics functional immaturity of the colon
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hirschsprungs
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What are the imaging findings of functional immaturity fo the colon
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-Multiple dilated bowel loops in neonate
-Small left colon to the splenic flexure -Abrupt zone of transition to dilated proximal colon at the splenic flexure -Multiple filling defects may fill left colon (meconium), but not required Best imaging tool: Water-soluble contrast enema |
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What is the best imaging study when evaluating a lower bowel obstruction in a child
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Best imaging tool: Water-soluble contrast enema
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What is the pathology of hirschsprungs
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arrest of ganglion cells results in abscence distally. The bowel is unable to relax without these cells
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What are 2 associations with hirshsprungs
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downs
congenital neuroblastoma |
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What is normaly bigger the rectum or sigmoid
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rectum (reversed in hirshsprungs
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When does hirschsprungs mimic functional immaturity of the colon
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when hirschsprungs is long segment
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Can hirschsprungs involve the entire colon
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yes
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What are the classifications of imperforate anus
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high (above the puboretalis sling) and low
important to know because it changes surgical approach |
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What is a common complication of an imperforate anus
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rectourethral fistula
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What is the mc age of pyloric stenosis
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1wk-3mo
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What is the abnormal diameter of the appendix in US
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>6 mm non-compressible
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What is the MC type of intussusception
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ileocolic
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What is the intussusceptum
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the ileum
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what is the intussuscipien
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colon
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What is the cause of the intussuception
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hypertrophy of peyers patches
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What is the typical age of intussusception |
3 months to 2 years
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What should be concerned about if the patient is older than 2 years
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lead point
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What is the typical presentation
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colicky abdominal pain, vomitting, bloody currant jelly stool.
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What is the contraindication to reduce an intussusception
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free air or pneumotosis
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What is required prior to reducing an intussusception
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plain film to rule out the contridincations
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What does the mucosa and muscularis look like on plain flim
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mucosa-echogenic
muscularis-hypoechoic |
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Where is the 2nd mc location of intussusception
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the transverse colon
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Beside appendicitis, pyloric stenosis and intussuception what is another emergent abominal finding to look for |
incarcerated inguinal hernia
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What are some causes of conjugated hyperbilirubinemia |
neonatal hepatitis, biliary atresia, choledochal cyst, inborn error of metabolismm
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