duodenal atresia
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This document provides an overview of duodenal atresia, including its definition, epidemiology, etiology, clinical features, diagnosis, management, complications, and differential diagnosis. Duodenal atresia is a congenital absence or closure of part of the duodenum due to defective fusion during development. It commonly presents after birth with vomiting, jaundice, and abdominal distension. Diagnosis is typically made through imaging findings like the "double bubble" sign on x-ray. Surgical management involves bypassing the blocked portion of duodenum through procedures like duodenoduodenostomy. Complications can include anastomotic issues or problems from associated anomalies.
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Duodenal atresia
Duodenal atresia is a common cause of intestinal obstruction in neonates, occurring in about 1 in 5,000-10,000 live births. It results from a failure of recanalization of the fetal duodenum, leading to a complete obstruction. Clinically, it presents with bilious vomiting within the first few hours of life. Diagnosis involves finding the classic "double bubble" sign on abdominal x-ray. Surgical treatment involves reconstructing bowel continuity, usually via a diamond-shaped duodenoduodenostomy. With proper management, over 95% of patients will recover successfully from duodenal atresia.
Omphalocele vs gastroschisis
This document discusses abdominal wall defects, specifically omphalocele and gastroschisis. Omphalocele is a birth defect where abdominal organs protrude out of the belly button, which is covered by a sac-like membrane. Gastroschisis is where the intestines protrude out of the abdominal wall to the right of the umbilical cord without a protective sac. Prenatal ultrasound can diagnose these conditions. Treatment for omphalocele may involve conservative management with a sac or surgical closure, while gastroschisis typically requires primary closure. Long-term outcomes depend on the severity of the defect and presence of other anomalies, with generally good prognosis if no other issues are present.
Imperforate Anus
The document discusses the development of the anal canal and the surgical anatomy of the anal canal. It describes different types of imperforate anus including low and high anomalies. Low anomalies include covered anus, ectopic anus, and stenosed anus. High anomalies include anorectal agenesis, rectal atresia, and cloaca. Initial management involves assessing whether temporary colostomy is needed. Treatment of low anomalies involves dilatations or procedures like V-Y anoplasty or cutback procedure. Treatment of high anomalies includes initial colostomy followed by posterior sagittal anorectoplasty to reconstruct the anal canal. Surgical outcomes vary depending on the type of anomaly repaired.
Anorectal malformation
Anorectal malformations refer to anomalies of the rectum and anus that have an incidence of approximately 1 in 5000 live births. They can range from a simple imperforate anus to more complex anomalies associated with genitourinary and pelvic organs. Anorectal malformations are frequently associated with other anomalies as well, such as VACTERL. Surgical treatment depends on the specific defect but may include procedures such as posterior sagittal anorectoplasty. Postoperative nursing care focuses on pain management, maintaining appropriate skin care and drainage, and educating parents on ostomy and wound care.
Abdominal wall defects
This document provides information on abdominal wall defects, specifically omphalocele and gastroschisis. It discusses the epidemiology, etiology, clinical features, diagnosis, management, and prognosis of each condition. Omphalocele is caused by failure of the midgut to return to the abdomen during development. It presents as abdominal organs herniated within a sac. Gastroschisis is caused by failure of abdominal wall closure and presents as bowel protruding through an abdominal wall defect without a sac. Management may include prenatal monitoring, temporary covering of exposed organs, surgery to repair the defect, and treatment of any associated anomalies or complications. Outcomes depend on the severity of each case and presence of other birth defects
GASTROSCHISIS
Gastroschisis is a birth defect where a hole in the abdominal wall allows intestines to protrude outside the baby's body. It occurs in about 0.1-0.3% of live births. The defect is usually on the right side of the belly button, with no protective sac covering the intestines. Treatment involves surgery to return the intestines to the abdominal cavity. Nursing care focuses on keeping the exposed intestines warm and sterile, managing fluids and nutrition, and monitoring for complications like infection or obstruction. Primary repair is preferred if the intestines will fit back inside, otherwise a staged repair using a synthetic sac is required.
Diaphragmatic hernia
1) A diaphragmatic hernia is a defect in the diaphragm allowing contents from the abdomen to protrude into the chest cavity.
2) Congenital diaphragmatic hernias are the most common type and occur during fetal development when the diaphragm fails to fully form.
3) Infants present with respiratory distress and treatment involves aggressive respiratory support, surgical repair of the defect, and long term management of complications which can include GERD and intestinal issues.
Intussusception (2)
Intussusception is the telescoping of one part of the intestine into another part and is most common in children under 2 years old. The classic presentation includes intermittent abdominal pain, a sausage-shaped abdominal mass, and currant jelly stools. Ultrasound is the preferred diagnostic method and shows a target or "doughnut" sign. Treatment involves rehydration and antibiotics if infected. Non-operative reduction using hydrostatic or pneumatic pressure is usually attempted first but surgery may be needed if reduction fails or there are signs of perforation or necrosis. With prompt diagnosis and treatment, mortality from intussusception is less than 1%.
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Duodenal atresia
Duodenal atresia is a common cause of intestinal obstruction in neonates, occurring in about 1 in 5,000-10,000 live births. It results from a failure of recanalization of the fetal duodenum, leading to a complete obstruction. Clinically, it presents with bilious vomiting within the first few hours of life. Diagnosis involves finding the classic "double bubble" sign on abdominal x-ray. Surgical treatment involves reconstructing bowel continuity, usually via a diamond-shaped duodenoduodenostomy. With proper management, over 95% of patients will recover successfully from duodenal atresia.
Omphalocele vs gastroschisis
This document discusses abdominal wall defects, specifically omphalocele and gastroschisis. Omphalocele is a birth defect where abdominal organs protrude out of the belly button, which is covered by a sac-like membrane. Gastroschisis is where the intestines protrude out of the abdominal wall to the right of the umbilical cord without a protective sac. Prenatal ultrasound can diagnose these conditions. Treatment for omphalocele may involve conservative management with a sac or surgical closure, while gastroschisis typically requires primary closure. Long-term outcomes depend on the severity of the defect and presence of other anomalies, with generally good prognosis if no other issues are present.
Imperforate Anus
The document discusses the development of the anal canal and the surgical anatomy of the anal canal. It describes different types of imperforate anus including low and high anomalies. Low anomalies include covered anus, ectopic anus, and stenosed anus. High anomalies include anorectal agenesis, rectal atresia, and cloaca. Initial management involves assessing whether temporary colostomy is needed. Treatment of low anomalies involves dilatations or procedures like V-Y anoplasty or cutback procedure. Treatment of high anomalies includes initial colostomy followed by posterior sagittal anorectoplasty to reconstruct the anal canal. Surgical outcomes vary depending on the type of anomaly repaired.
Anorectal malformation
Anorectal malformations refer to anomalies of the rectum and anus that have an incidence of approximately 1 in 5000 live births. They can range from a simple imperforate anus to more complex anomalies associated with genitourinary and pelvic organs. Anorectal malformations are frequently associated with other anomalies as well, such as VACTERL. Surgical treatment depends on the specific defect but may include procedures such as posterior sagittal anorectoplasty. Postoperative nursing care focuses on pain management, maintaining appropriate skin care and drainage, and educating parents on ostomy and wound care.
Abdominal wall defects
This document provides information on abdominal wall defects, specifically omphalocele and gastroschisis. It discusses the epidemiology, etiology, clinical features, diagnosis, management, and prognosis of each condition. Omphalocele is caused by failure of the midgut to return to the abdomen during development. It presents as abdominal organs herniated within a sac. Gastroschisis is caused by failure of abdominal wall closure and presents as bowel protruding through an abdominal wall defect without a sac. Management may include prenatal monitoring, temporary covering of exposed organs, surgery to repair the defect, and treatment of any associated anomalies or complications. Outcomes depend on the severity of each case and presence of other birth defects
GASTROSCHISIS
Gastroschisis is a birth defect where a hole in the abdominal wall allows intestines to protrude outside the baby's body. It occurs in about 0.1-0.3% of live births. The defect is usually on the right side of the belly button, with no protective sac covering the intestines. Treatment involves surgery to return the intestines to the abdominal cavity. Nursing care focuses on keeping the exposed intestines warm and sterile, managing fluids and nutrition, and monitoring for complications like infection or obstruction. Primary repair is preferred if the intestines will fit back inside, otherwise a staged repair using a synthetic sac is required.
Diaphragmatic hernia
1) A diaphragmatic hernia is a defect in the diaphragm allowing contents from the abdomen to protrude into the chest cavity.
2) Congenital diaphragmatic hernias are the most common type and occur during fetal development when the diaphragm fails to fully form.
3) Infants present with respiratory distress and treatment involves aggressive respiratory support, surgical repair of the defect, and long term management of complications which can include GERD and intestinal issues.
Intussusception (2)
Intussusception is the telescoping of one part of the intestine into another part and is most common in children under 2 years old. The classic presentation includes intermittent abdominal pain, a sausage-shaped abdominal mass, and currant jelly stools. Ultrasound is the preferred diagnostic method and shows a target or "doughnut" sign. Treatment involves rehydration and antibiotics if infected. Non-operative reduction using hydrostatic or pneumatic pressure is usually attempted first but surgery may be needed if reduction fails or there are signs of perforation or necrosis. With prompt diagnosis and treatment, mortality from intussusception is less than 1%.
omphalocele and gastroschisis
This document discusses the embryology, diagnosis, and treatment of two congenital abdominal wall defects: gastroschisis and omphalocele.
Gastroschisis results from a failure of the lateral body folds to migrate, causing intestines to protrude through an abdominal wall defect to the right of the umbilicus. Prenatal ultrasound can diagnose it by 20 weeks. Treatment involves either primary closure or staged closure using a silo.
Omphalocele occurs when organs fail to return to the abdominal cavity during development, causing them to remain in the umbilical cord. It can involve liver and intestines protruding in a sac. Treatment options depend on size and may include immediate or staged
Congenital diaphragmatic hernia by Dr. Varsha Atul Shah
Dr. Varsha Atul Shah presented on congenital diaphragmatic hernia (CDH). CDH occurs when abdominal organs protrude into the chest cavity through a hole in the diaphragm. It has an incidence of 1 in 2000-3000 live births. Clinically, CDH presents with respiratory distress in newborns. Treatment involves medical management in the NICU with ventilator support, medications to manage blood pressure and oxygen levels, and surgery to repair the diaphragmatic defect. Outcomes have improved but mortality remains high depending on the severity of lung hypoplasia and pulmonary hypertension.
Anorectal malformation
Anorectal malformations are developmental deformities of the lower end of the alimentary tract that occur due to arrest in embryonic development between weeks 4-12. They range from minor abnormalities like anal stenosis to major ones where there is no anal opening. Surgical correction depends on type and aims to reconstruct bowel continuity. Post-operative care focuses on perineal care, feeding, bowel habits and prevention of complications like infection and obstruction. Prognosis is good for most, with majority achieving bowel control.
Pediatric Intussusception - An Overview
This document discusses intussusception, which is the telescoping of one segment of bowel into an adjacent segment. It provides definitions, etiology, types and pathology, signs and symptoms, differential diagnosis, workup, and treatment options for intussusception. The main points are that intussusception is usually idiopathic or caused by respiratory viruses in infants and young children, presenting with abdominal pain, vomiting, and bloody stools. Diagnosis involves imaging like ultrasound or barium enema. Treatment options include non-surgical reduction techniques like hydrostatic or pneumatic reduction or surgical reduction through manual manipulation or resection.
229688251 omphalocele
This document discusses abdominal wall defects including omphalocele, gastroschisis, and hernia of the umbilical cord. It provides details on the formation, characteristics, associated anomalies, management, and outcomes of each condition. Omphalocele is defined as a defect covered by a membrane with the umbilical cord inserting into the sac, often containing herniated bowel or liver. Gastroschisis is a smaller lateral defect without a covering sac, exposing edematous bowel. Hernia of the umbilical cord occurs later in gestation from failure of umbilical ring closure. Prenatal diagnosis allows for counseling and delivery at specialized centers. Surgical repair is typically performed though staged if
Hirschsprung's disease
Hirschsprung's disease is a congenital disorder caused by the absence of ganglion cells in parts of the colon, which prevents normal nerve function. It most commonly involves the rectum and sigmoid colon. Affected infants experience constipation or intestinal obstruction after birth. Diagnosis involves rectal biopsy and imaging tests. Treatment involves surgically removing the affected part of the colon and reconnecting the healthy ends, which often cures the condition. Complications can include infection, leakage at the connection site, or ongoing constipation issues.
Esophageal atresia
This document discusses esophageal atresia, a birth defect where the esophagus is not connected resulting in the inability to swallow. It occurs in about 1 in 2500-3000 births. There are various types classified by location and presence of a tracheoesophageal fistula. Associated anomalies are also common. Diagnosis involves x-rays and endoscopy to confirm lack of passage. Management involves surgical correction either immediately if stable or staged if complications exist, to reconnect the esophagus. Complications can include leaks, strictures or gastroesophageal reflux long term. Early diagnosis and surgical repair improve prognosis.
Intussusception
This document provides information on intussusception in children. It discusses that intussusception is the telescoping of one segment of intestine into another and is most common in children under 1 year old. It can be idiopathic or have a pathological lead point such as Meckel's diverticulum. Diagnosis is usually made clinically or with ultrasound or contrast enema. Treatment involves non-operative reduction with hydrostatic or pneumatic enema, which has a high success rate. Surgery is needed if reduction fails or there are complications like perforation. Prognosis is generally excellent with prompt treatment.
Volvulus
This document outlines the presentation, causes, diagnosis, treatment, and nursing care of volvulus, which is the twisting of a loop of intestine that cuts off blood flow. It most commonly affects the sigmoid colon. Key points include that volvulus can be acute, sub-acute, or chronic; surgical intervention is usually needed to untwist the intestine; and nursing care involves pain management, fluid replacement, monitoring for complications, and educating patients and families.
Choledochal cyst
1. Choledochal cysts are abnormal dilations of the bile ducts that are more common in Asia and women.
2. They are classified into 5 types based on location and extent of dilation.
3. Presentation varies from jaundice and abdominal mass in children to pain and cholangitis in older patients.
4. Investigation involves ultrasound, CT, MRCP and cholangiography to determine type and rule out complications.
5. Treatment is complete excision of the cysts and biliary tree with Roux-en-Y hepaticojejunostomy, except for type III which can be managed endoscopically.
Intestinal atresia
This document discusses intestinal atresia and obstruction. It begins by defining the two types of intestinal obstruction - simple and strangulating. It then covers the pathophysiology, causes including congenital lesions, clinical presentation depending on location and severity of obstruction, investigations including imaging and labs, and management including initial stabilization, surgery, and specific approaches for different types of atresia like duodenal and jejunal/ileal atresia. It also discusses related conditions like meconium ileus. The document provides detailed information on evaluating and treating neonatal intestinal obstruction.
Neonatal intestinal obstruction
This document discusses various types of intestinal obstructions in neonates. It describes high intestinal obstructions, which occur proximal to the ileum such as gastric, duodenal or jejunal obstructions. It also describes low intestinal obstructions, which occur distal to the ileum and in the colon. Specific causes of obstruction discussed include duodenal atresia, intestinal malrotation, necrotizing enterocolitis, meconium ileus and Hirschsprung's disease. Diagnosis involves abdominal x-rays and contrast studies to identify the location and cause of obstruction.
Malrotation of gut
This document discusses intestinal malrotation, beginning with a definition and incidence. It describes the normal stages of intestinal rotation during embryonic development and defines different types of rotational disorders including nonrotation, incomplete rotation, and reverse rotation. Clinical presentations are outlined for acute midgut volvulus, chronic midgut volvulus, acute duodenal obstruction, and internal hernia. Radiologic findings that help diagnose malrotation are presented. Treatment involves reducing the risk of volvulus recurrence through the Ladd's procedure. Post-operative care and potential complications are also summarized.
Hirschsprung Disease - Approach & Management
Hirschsprung Disease. - A developmental Disorder of Intrinsic Component of Enteric Nervous System.
Also known Congenital Megacolon.
This Presentation deals with The eitology, presentation, diagnosis, medical and surgical management & complications of the same.
Meconium ileus Simple
Meconium ileus is a neonatal intestinal obstruction caused by thickened meconium within the bowel lumen. It occurs in approximately 20% of cystic fibrosis patients and risk factors include a family history of cystic fibrosis or meconium ileus, as well as low birth weight. Thickened meconium leads to obstruction in the bowel, dilation of the proximal ileum, and narrowing of the distal intestine. Symptoms include failure to pass meconium and abdominal distension. Treatment options include non-operative hyperosmolar enemas to break down the thickened meconium or operative resection with enterostomy or primary anastomosis for complicated cases.
Biliary Atresia
Biliary atresia is a condition where the bile ducts outside the liver are blocked. It is the most common cause of jaundice in newborns that requires surgery. The surgery, called a Kasai procedure, involves removing any remaining blocked bile ducts and connecting the liver directly to the intestine to drain bile. Even with surgery, about half of children will develop progressive liver damage requiring transplantation. Early diagnosis before 3 months of age and surgery improve the chances of successful bile drainage and liver function.
CONGENITAL HERNIA AND HYDROCELE
This document discusses congenital inguinal hernia and hydrocele. It notes that a congenital inguinal hernia occurs when the processus vaginalis fails to close after testicular descent in fetal development, allowing abdominal contents to enter the scrotum. It has a high rate in premature infants and is more common in males. A hydrocele occurs when the processus vaginalis remains fluid-filled but no abdominal contents enter. Both often resolve spontaneously in infants but may require surgery if persisting past 2 years. The hernia repair procedure involves high ligation of the hernia sac at the internal ring through an inguinal incision.
abdominal wall defect
Gastroschisis and omphalocele are the two most common abdominal wall defects. Gastroschisis involves intestines protruding through an abdominal wall defect without a membrane covering, while omphalocele involves intestines covered by a membrane through an umbilical defect. Outcomes depend on associated anomalies, which are more common with omphalocele. Prenatal diagnosis allows for delivery planning, and management focuses on stabilization, careful examination for other issues, and surgical closure of the abdominal wall defect. Long-term outcomes depend on the presence of other anomalies.
Short bowel syndrome
1. Short bowel syndrome results from surgical resection or disease that leaves the small intestine unable to absorb enough nutrients from food.
2. It occurs when there is less than 200cm of small intestine remaining or a loss of over 50% of the small intestine.
3. Patients experience malabsorption, diarrhea, fluid and electrolyte disturbances, and require intravenous nutrition to supplement what they cannot absorb from food.
4. Over time, the remaining intestine can adapt through changes like villous hyperplasia, but patients often still require long-term treatments and supplements.
Undescended testis
Gaurav Nahar discusses undescended testis (cryptorchidism). Cryptorchidism occurs when one or both testes fail to descend into the scrotum. It has a prevalence of 1-4% in full term males and 1-45% in preterm males. Testicular descent is a complex process involving hormonal and mechanical factors. Cryptorchidism can be congenital, acquired, or syndromic. Evaluation involves history, exam to locate any undescended testes, and sometimes imaging or labs. Treatment is usually surgical orchidopexy to position testes in scrotum.
Hydronephrosis Dr Lokku
Hydronephrosis is the dilation of the renal pelvis and calyces, which can be caused by obstruction of urine flow. It is commonly detected during prenatal ultrasound screening. Common causes in neonates include ureteropelvic junction obstruction, posterior urethral valves, and vesicoureteral reflux. Treatment depends on the severity and includes antibiotics, surgery to repair obstructions, and management of any associated renal issues.
Rectal diseases
This document discusses various rectal diseases including prolapse, proctitis, polyps, benign lesions, and carcinoma. Rectal prolapse is classified as mucosal or full-thickness and can be caused by straining, weak pelvic floor muscles, or trauma from childbirth. Treatment depends on the type but may include injections, banding, or surgery. Proctitis is inflammation that can be caused by infection, radiation, or inflammatory bowel disease. Polyps are growths that can be removed endoscopically if small or via surgery if large. Benign lesions include endometriosis, hemangiomas, and neuroendocrine tumors. Rectal carcinoma is often treated with surgery such as anterior resection or
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This document discusses the embryology, diagnosis, and treatment of two congenital abdominal wall defects: gastroschisis and omphalocele.
Gastroschisis results from a failure of the lateral body folds to migrate, causing intestines to protrude through an abdominal wall defect to the right of the umbilicus. Prenatal ultrasound can diagnose it by 20 weeks. Treatment involves either primary closure or staged closure using a silo.
Omphalocele occurs when organs fail to return to the abdominal cavity during development, causing them to remain in the umbilical cord. It can involve liver and intestines protruding in a sac. Treatment options depend on size and may include immediate or staged
Congenital diaphragmatic hernia by Dr. Varsha Atul Shah
Dr. Varsha Atul Shah presented on congenital diaphragmatic hernia (CDH). CDH occurs when abdominal organs protrude into the chest cavity through a hole in the diaphragm. It has an incidence of 1 in 2000-3000 live births. Clinically, CDH presents with respiratory distress in newborns. Treatment involves medical management in the NICU with ventilator support, medications to manage blood pressure and oxygen levels, and surgery to repair the diaphragmatic defect. Outcomes have improved but mortality remains high depending on the severity of lung hypoplasia and pulmonary hypertension.
Anorectal malformation
Anorectal malformations are developmental deformities of the lower end of the alimentary tract that occur due to arrest in embryonic development between weeks 4-12. They range from minor abnormalities like anal stenosis to major ones where there is no anal opening. Surgical correction depends on type and aims to reconstruct bowel continuity. Post-operative care focuses on perineal care, feeding, bowel habits and prevention of complications like infection and obstruction. Prognosis is good for most, with majority achieving bowel control.
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This document discusses intussusception, which is the telescoping of one segment of bowel into an adjacent segment. It provides definitions, etiology, types and pathology, signs and symptoms, differential diagnosis, workup, and treatment options for intussusception. The main points are that intussusception is usually idiopathic or caused by respiratory viruses in infants and young children, presenting with abdominal pain, vomiting, and bloody stools. Diagnosis involves imaging like ultrasound or barium enema. Treatment options include non-surgical reduction techniques like hydrostatic or pneumatic reduction or surgical reduction through manual manipulation or resection.
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This document discusses abdominal wall defects including omphalocele, gastroschisis, and hernia of the umbilical cord. It provides details on the formation, characteristics, associated anomalies, management, and outcomes of each condition. Omphalocele is defined as a defect covered by a membrane with the umbilical cord inserting into the sac, often containing herniated bowel or liver. Gastroschisis is a smaller lateral defect without a covering sac, exposing edematous bowel. Hernia of the umbilical cord occurs later in gestation from failure of umbilical ring closure. Prenatal diagnosis allows for counseling and delivery at specialized centers. Surgical repair is typically performed though staged if
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Hirschsprung's disease is a congenital disorder caused by the absence of ganglion cells in parts of the colon, which prevents normal nerve function. It most commonly involves the rectum and sigmoid colon. Affected infants experience constipation or intestinal obstruction after birth. Diagnosis involves rectal biopsy and imaging tests. Treatment involves surgically removing the affected part of the colon and reconnecting the healthy ends, which often cures the condition. Complications can include infection, leakage at the connection site, or ongoing constipation issues.
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This document discusses esophageal atresia, a birth defect where the esophagus is not connected resulting in the inability to swallow. It occurs in about 1 in 2500-3000 births. There are various types classified by location and presence of a tracheoesophageal fistula. Associated anomalies are also common. Diagnosis involves x-rays and endoscopy to confirm lack of passage. Management involves surgical correction either immediately if stable or staged if complications exist, to reconnect the esophagus. Complications can include leaks, strictures or gastroesophageal reflux long term. Early diagnosis and surgical repair improve prognosis.
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This document outlines the presentation, causes, diagnosis, treatment, and nursing care of volvulus, which is the twisting of a loop of intestine that cuts off blood flow. It most commonly affects the sigmoid colon. Key points include that volvulus can be acute, sub-acute, or chronic; surgical intervention is usually needed to untwist the intestine; and nursing care involves pain management, fluid replacement, monitoring for complications, and educating patients and families.
Choledochal cyst
1. Choledochal cysts are abnormal dilations of the bile ducts that are more common in Asia and women.
2. They are classified into 5 types based on location and extent of dilation.
3. Presentation varies from jaundice and abdominal mass in children to pain and cholangitis in older patients.
4. Investigation involves ultrasound, CT, MRCP and cholangiography to determine type and rule out complications.
5. Treatment is complete excision of the cysts and biliary tree with Roux-en-Y hepaticojejunostomy, except for type III which can be managed endoscopically.
Intestinal atresia
This document discusses intestinal atresia and obstruction. It begins by defining the two types of intestinal obstruction - simple and strangulating. It then covers the pathophysiology, causes including congenital lesions, clinical presentation depending on location and severity of obstruction, investigations including imaging and labs, and management including initial stabilization, surgery, and specific approaches for different types of atresia like duodenal and jejunal/ileal atresia. It also discusses related conditions like meconium ileus. The document provides detailed information on evaluating and treating neonatal intestinal obstruction.
Neonatal intestinal obstruction
This document discusses various types of intestinal obstructions in neonates. It describes high intestinal obstructions, which occur proximal to the ileum such as gastric, duodenal or jejunal obstructions. It also describes low intestinal obstructions, which occur distal to the ileum and in the colon. Specific causes of obstruction discussed include duodenal atresia, intestinal malrotation, necrotizing enterocolitis, meconium ileus and Hirschsprung's disease. Diagnosis involves abdominal x-rays and contrast studies to identify the location and cause of obstruction.
Malrotation of gut
This document discusses intestinal malrotation, beginning with a definition and incidence. It describes the normal stages of intestinal rotation during embryonic development and defines different types of rotational disorders including nonrotation, incomplete rotation, and reverse rotation. Clinical presentations are outlined for acute midgut volvulus, chronic midgut volvulus, acute duodenal obstruction, and internal hernia. Radiologic findings that help diagnose malrotation are presented. Treatment involves reducing the risk of volvulus recurrence through the Ladd's procedure. Post-operative care and potential complications are also summarized.
Hirschsprung Disease - Approach & Management
Hirschsprung Disease. - A developmental Disorder of Intrinsic Component of Enteric Nervous System.
Also known Congenital Megacolon.
This Presentation deals with The eitology, presentation, diagnosis, medical and surgical management & complications of the same.
Meconium ileus Simple
Meconium ileus is a neonatal intestinal obstruction caused by thickened meconium within the bowel lumen. It occurs in approximately 20% of cystic fibrosis patients and risk factors include a family history of cystic fibrosis or meconium ileus, as well as low birth weight. Thickened meconium leads to obstruction in the bowel, dilation of the proximal ileum, and narrowing of the distal intestine. Symptoms include failure to pass meconium and abdominal distension. Treatment options include non-operative hyperosmolar enemas to break down the thickened meconium or operative resection with enterostomy or primary anastomosis for complicated cases.
Biliary Atresia
Biliary atresia is a condition where the bile ducts outside the liver are blocked. It is the most common cause of jaundice in newborns that requires surgery. The surgery, called a Kasai procedure, involves removing any remaining blocked bile ducts and connecting the liver directly to the intestine to drain bile. Even with surgery, about half of children will develop progressive liver damage requiring transplantation. Early diagnosis before 3 months of age and surgery improve the chances of successful bile drainage and liver function.
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This document discusses congenital inguinal hernia and hydrocele. It notes that a congenital inguinal hernia occurs when the processus vaginalis fails to close after testicular descent in fetal development, allowing abdominal contents to enter the scrotum. It has a high rate in premature infants and is more common in males. A hydrocele occurs when the processus vaginalis remains fluid-filled but no abdominal contents enter. Both often resolve spontaneously in infants but may require surgery if persisting past 2 years. The hernia repair procedure involves high ligation of the hernia sac at the internal ring through an inguinal incision.
abdominal wall defect
Gastroschisis and omphalocele are the two most common abdominal wall defects. Gastroschisis involves intestines protruding through an abdominal wall defect without a membrane covering, while omphalocele involves intestines covered by a membrane through an umbilical defect. Outcomes depend on associated anomalies, which are more common with omphalocele. Prenatal diagnosis allows for delivery planning, and management focuses on stabilization, careful examination for other issues, and surgical closure of the abdominal wall defect. Long-term outcomes depend on the presence of other anomalies.
Short bowel syndrome
1. Short bowel syndrome results from surgical resection or disease that leaves the small intestine unable to absorb enough nutrients from food.
2. It occurs when there is less than 200cm of small intestine remaining or a loss of over 50% of the small intestine.
3. Patients experience malabsorption, diarrhea, fluid and electrolyte disturbances, and require intravenous nutrition to supplement what they cannot absorb from food.
4. Over time, the remaining intestine can adapt through changes like villous hyperplasia, but patients often still require long-term treatments and supplements.
Undescended testis
Gaurav Nahar discusses undescended testis (cryptorchidism). Cryptorchidism occurs when one or both testes fail to descend into the scrotum. It has a prevalence of 1-4% in full term males and 1-45% in preterm males. Testicular descent is a complex process involving hormonal and mechanical factors. Cryptorchidism can be congenital, acquired, or syndromic. Evaluation involves history, exam to locate any undescended testes, and sometimes imaging or labs. Treatment is usually surgical orchidopexy to position testes in scrotum.
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Rectal diseases
This document discusses various rectal diseases including prolapse, proctitis, polyps, benign lesions, and carcinoma. Rectal prolapse is classified as mucosal or full-thickness and can be caused by straining, weak pelvic floor muscles, or trauma from childbirth. Treatment depends on the type but may include injections, banding, or surgery. Proctitis is inflammation that can be caused by infection, radiation, or inflammatory bowel disease. Polyps are growths that can be removed endoscopically if small or via surgery if large. Benign lesions include endometriosis, hemangiomas, and neuroendocrine tumors. Rectal carcinoma is often treated with surgery such as anterior resection or
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Dear Viewers,
Greetings from “Surgical Educator”.
I have made a playlist for Lower GI Hemorrhage which consists of six videos on various causes of Lower GI Hemorrhage. They are Introduction, diverticular disease, haemorrhoids, fissure-in-ano, colorectal carcinoma and inflammatory bowel disease. If you watch all these videos together you will become confident to tackle the clinical problem of Lower GI Hemorrhage. You can watch these videos in the following link: https://www.youtube.com/playlist…
Thank you for watching the videos.
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Cystic Fibrosis "Overview of Gastrointestinal Diseases"
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duodenal atresia
- 1. BY SHREOSI GHOSH INTERN MALDA MEDICAL COLLEGE AND HOSPITAL
- 2. INTRODUCTION DEFFINITION: Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum due to the defective fusion of foregut and midgut with failure of the recanalisation. EPIDEMIOLOGY: 1 Per 5000 to 10000 live births. Affecting boys more commonly than girls.
- 3. ETIOLOGY Intrinsic lesion: Caused by failure of recanalization of the fetal duodenum Extrinsic lesion: Defects in the development of the neighbouring structures Teratogens: Chlordiazepoxide Thalidomide Flurouracil
- 4. ASSOCIATIONS 1. Prematurity (45%) 2. Growth retardation (33%) 3. Annular pancreas 4. Down’s syndrome (30%) – Trisomy 21 5. Miller-Dieker syndrome 6. More than 50% patients have associated congenital anomalies – Congenital heart disease (30%) Incomplete rotation of gut (20%) Anorectal malformations (10%)
- 5. CLASSIFICATION ANATOMICAL CLASSIFICATION: A. TYPE 1 (92%):Complete atresia B. TYPE 2 (1%):Fibrous cord separating two ends C. TYPE 3 (7%):Incomplete or partial obstruction Stenosis Mucosal web with intact muscular wall-WINDSOCK DEFFORMITY
- 7. CLASSIFICATION CONTD… SITE WISE CLASSIFICATION: PREAMPULLARY (10-15% ) POSTAMPULLARY (85-90% )
- 8. PATHOPHYSIOLOGY Failure of canalization of the duodenal lumen Improper formation of vacuoles Atresia or web may develop Accumulation of gases and secretions above the blockage
- 9. In intra luminal pressure , venous pressure Circulatory stasis or edema Gangrene, Peritonitis
- 10. CLINICAL FEATURES Bilious or nonbilious vomiting immediately after birth Jaundice Features of gastric outlet obstruction Dehydration and electrolytes changes Abdominal distension and tenderness Absence of flatus No passage of stool Respiratory distress Shock
- 11. DIAGNOSIS History: Maternal polyhydramnios Investigations: 1. MATERNAL - Prenatal ultrasonography: a. Detects duodenal atresia between 7th and 8th month of gestation. b. Polyhydramnios and associated anomalies can also be detected.
- 13. 2. CHILD Plain X ray abdomen: DOUBLE BUBBLE SIGN with absence of air in the distal part
- 14. INVESTIGATION CONTD… Upper GI contrast study: a. Partial obstruction with the presence of air in the distal loop b. Other associated anomalies – Malrotation,Mid gut volvulus etc
- 15. INVESTIGATION CONTD… Ultrasonography abdomen: Distended stomach and proximal Duodenum – RAIL ROAD TRACK DUODENUM
- 16. MANAGEMENT GENERAL MANAGEMENT : IV fluids Oro or nasogastric aspiration Stomach wash NPM Antibiotics,antiemetics,vitamin K supplement,PPI
- 17. SURGICAL MANAGEMENT : PREOPERATIVE CARE : Appropriate resuscitation Correction of fluid imbalance and electrolyte abnormalities Monitoring of the complete metabolic profile Gastric decompression Perenteral nutrition via central catheter line Two dimensional echocardiographic monitoring
- 18. TREATMENT PROPER: Surgery can be done by: LAPAROTOMY: Supraumbilical transverse incision is given to the right upper quadrant of abdomen LAPAROSCOPY: Neonatal laparoscopic instruments (3mm ) and Trocars are used
- 20. TREATMENT CONTD… Different Methods are : DUODENODUODENOSTOMY: Surgical bypass for the duodenal obstruction is done by Side to side Duodenoduodenostomy.Associated malrotation should also be corrected (LADD’S OPERATION). Megaduodenum or anstomotic dysfunction can occur.
- 21. Kimura’s diamond shaped anstomosis: Done between transversly opened proximal pouch and longitudinally opened distal pouch.Presence of bile and concomittent distal atresia should be confirmed by saline irrigation. Less chances of the problems of anastomosis.
- 22. Treatment contd.. Tapering Duodenoplasty: Done with staples or sutures to reduce the Duodenal caliber when the proximal Duodenum is markedly dialated.
- 23. HEINEKE-MICULICZ DUODENOPLASTY: Partial web resection is done transduodenally in Duodenal mucosal web.
- 24. DUODENOJEJUNOSTOMY: Previously preferred technique. May cause blind loop problem. GASTROJEJUNOSTOMY: Done previously. High incidence of marginal ulceration and bleeding.
- 25. UPPER GI CONTRAST STUDY AFTER LAPAROSCOPY
- 26. POST OPERATIVE CARE Continuation of Total parenteral nutrition (TPN) Monitoring of Nasogastric tube output Feeding via transanastomotic nasojejunal or gastrostomy tube after diminution of nasogastric tube output Small feeding with volume and concentration advanced as tolerated Discharge within one to three weeks
- 27. COMPLICATIONS INTRAOPERATIVE : Windsock defformity (Floppy web) : Incorrect identification of site of obstruction Bypass anstomosis entirely distal to true web attachment Multiple obstructions POST OPERATIVE : Megaduodenum (30%) Prolonged feeding intolerance Poor peristalsis Residual obstruction Anastomotic stenosis
- 28. DIFFERENTIAL DIAGNOSIS Late appearing pyloric stenosis Incomplete diaphragm Other forms of intestinal atresia Duodenal duplication Midgut volvulus
- 30. THANK YOU