Acute intussusception
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Acute intussusception is the invagination of one segment of the intestine within the adjacent one. The main causes are idiopathic (70-95%) or associated with gastroenteritis. Clinically, it presents with abdominal pain, vomiting and bloody stools. Differential diagnoses include acute enterocolitis. Management involves history, examination, investigations and non-operative hydrostatic reduction is the first line treatment, with surgery if this fails or is contraindicated due to complications like obstruction or peritonitis.
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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.
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This document discusses acute abdominal pain in children, covering several topics:
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- The most common causes of acute abdominal pain in children, including gastroenteritis, appendicitis, constipation, and others.
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Volvulus is a twisting of the intestine resulting in blood vessel compression and ischemia. There are three main types: midgut, cecal, and sigmoid volvulus. Risk factors include chronic constipation, abnormal intestinal contents, and congenital malrotation. Signs include abdominal distension, pain, vomiting, and rapid heart rate. Diagnostic tests include abdominal x-rays, blood work, barium enema, and CT scan. Treatment depends on the type but may include surgery, sigmoidoscopy, or monitoring for signs of ischemia. Complications can be dehydration, ischemic bowel disease, perforation, peritonitis, and sepsis.
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This document discusses acute peritonitis, including:
- Peritonitis is defined as inflammation of the peritoneum and can be localized or generalized. It is usually caused by bacterial infection entering through the gastrointestinal tract or other sources.
- Symptoms depend on whether it is localized or diffuse. Localized peritonitis causes pain specific to the affected organ, while diffuse peritonitis causes generalized abdominal pain and tenderness.
- Treatment involves antibiotics, fluid resuscitation, and sometimes surgery to address the underlying cause and drain any abscesses. Outcomes depend on several factors but mortality is around 10% with prompt treatment. Complications can include shock, bowel obstruction, and residual infections.
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Abdominal mass
An abdominal mass can have various causes and require different treatments depending on the underlying condition. Examination of the patient and medical tests are needed to identify the location and cause of the mass. Common symptoms include abdominal pain, changes in appetite or bowel habits, weight changes, and the appearance of a mass. Serious symptoms may indicate life-threatening conditions like rapid mass growth or expansion accompanied by severe pain. Treatment options range from observation to surgery and may involve medications, drainage/removal of the mass, removal of part of an organ, or removal of the entire organ along with chemotherapy or radiation.
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.
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4. Investigation involves ultrasound, CT, MRCP and cholangiography to determine type and rule out complications.
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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 acute abdominal pain in children, covering several topics:
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- The most common causes of acute abdominal pain in children, including gastroenteritis, appendicitis, constipation, and others.
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Acute peritonitis
This document discusses acute peritonitis, including:
- Peritonitis is defined as inflammation of the peritoneum and can be localized or generalized. It is usually caused by bacterial infection entering through the gastrointestinal tract or other sources.
- Symptoms depend on whether it is localized or diffuse. Localized peritonitis causes pain specific to the affected organ, while diffuse peritonitis causes generalized abdominal pain and tenderness.
- Treatment involves antibiotics, fluid resuscitation, and sometimes surgery to address the underlying cause and drain any abscesses. Outcomes depend on several factors but mortality is around 10% with prompt treatment. Complications can include shock, bowel obstruction, and residual infections.
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An abdominal mass can have various causes and require different treatments depending on the underlying condition. Examination of the patient and medical tests are needed to identify the location and cause of the mass. Common symptoms include abdominal pain, changes in appetite or bowel habits, weight changes, and the appearance of a mass. Serious symptoms may indicate life-threatening conditions like rapid mass growth or expansion accompanied by severe pain. Treatment options range from observation to surgery and may involve medications, drainage/removal of the mass, removal of part of an organ, or removal of the entire organ along with chemotherapy or radiation.
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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.
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Intussusception in children
Intussusception is the invagination of one part of the intestine into another. It most commonly occurs in infants and children between 6 months and 2 years of age. Ultrasound is the preferred method of diagnosis as it can clearly visualize the "coiled-spring" or "bull's-eye" pattern of intussusception. Non-operative reduction using hydrostatic or pneumatic enema under fluoroscopic or ultrasound guidance is the first-line treatment and has high success rates of 80-95%. Surgical intervention is needed if non-operative reduction fails or if there is evidence of intestinal ischemia or perforation.
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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.
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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.
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Intestinal obstruction
Illustration of important clinical concepts regarding dynamic and adynamic intestinal obstruction in a concise manner
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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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Lipoma of the Small Intestine: A Cause for Intussusception in Adults
This case report describes a rare case of small intestinal intussusception in a 22-year-old male patient caused by a lipoma. Imaging including ultrasound and CT scan revealed the classic signs of intussusception and identified a likely lipoma as the cause. During surgery, an ileoileocolic intussusception was found and gently reduced, finding a submucosal lipoma as the pathological lead point. The involved intestinal segment containing the lipoma was resected. Histopathological examination confirmed the diagnosis of benign submucosal lipoma. The patient recovered well with no further symptoms.
Intussusception power point
A 9-month-old male presented with episodes of screaming in pain followed by calmness over several hours. On examination, he had a sausage-shaped mass in his right upper quadrant. Imaging showed characteristics indicative of intussusception, including a target sign. He received IV fluids and was admitted to the hospital for possible air contrast enema or ultrasound, as intussusception is a common cause of intestinal obstruction in this age group. Recurrence rates for intussusception are 5-10%.
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Intussusception in children
Intussusception is the invagination of one part of the intestine into another. It most commonly occurs in infants and children between 6 months and 2 years of age. Ultrasound is the preferred method of diagnosis as it can clearly visualize the "coiled-spring" or "bull's-eye" pattern of intussusception. Non-operative reduction using hydrostatic or pneumatic enema under fluoroscopic or ultrasound guidance is the first-line treatment and has high success rates of 80-95%. Surgical intervention is needed if non-operative reduction fails or if there is evidence of intestinal ischemia or perforation.
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This document discusses the acute abdomen, including its definition, common causes, symptoms, and physical examination findings. An acute abdomen is any sudden abdominal disorder requiring urgent operation. Common causes include appendicitis, cholecystitis, pancreatitis, and bowel obstructions. The history should clarify the location, onset, character, and relieving/aggravating factors of pain. The physical exam involves a full examination with focus on signs confirming or ruling out differential diagnoses.
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Illustration of important clinical concepts regarding dynamic and adynamic intestinal obstruction in a concise manner
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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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The small intestine is responsible for digestion and absorption of nutrients. It has three parts - duodenum, jejunum, and ileum. Common surgical conditions of the small intestine include small bowel obstruction, infections, inflammation, tumors, and diverticula. Mechanical obstruction from adhesions is the most common cause of small bowel obstruction. Strangulated obstruction can lead to ischemia and necrosis if not treated promptly.
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This document provides an overview of diarrhea in children, including definitions, epidemiology, etiology, pathophysiology, clinical manifestations, complications, evaluation, and management. Some key points include:
- Diarrhea is defined as >3 loose stools per day or watery stool of any frequency. It is a leading cause of death in children under 5 years old.
- Common causes are viral (e.g. rotavirus), bacterial (e.g. E.coli), and parasitic (e.g. Giardia).
- Complications include dehydration, malnutrition, and electrolyte imbalances.
- Management involves oral rehydration, continued feeding, and treating the underlying cause
Bladder exstrophy
This document discusses bladder exstrophy, a birth defect where the bladder is exposed through an abdominal wall defect. It notes there are three types - epispadias, bladder exstrophy, and cloacal exstrophy - and lists signs and differences between males and females. It describes pelvic osteotomy surgery to close the abdominal wall and partially tighten the bladder neck, as well as nursing management focusing on limiting trauma, infection monitoring, immobilization, and wound care.
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.
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Lipoma of the Small Intestine: A Cause for Intussusception in Adults
This case report describes a rare case of small intestinal intussusception in a 22-year-old male patient caused by a lipoma. Imaging including ultrasound and CT scan revealed the classic signs of intussusception and identified a likely lipoma as the cause. During surgery, an ileoileocolic intussusception was found and gently reduced, finding a submucosal lipoma as the pathological lead point. The involved intestinal segment containing the lipoma was resected. Histopathological examination confirmed the diagnosis of benign submucosal lipoma. The patient recovered well with no further symptoms.
Intussusception power point
A 9-month-old male presented with episodes of screaming in pain followed by calmness over several hours. On examination, he had a sausage-shaped mass in his right upper quadrant. Imaging showed characteristics indicative of intussusception, including a target sign. He received IV fluids and was admitted to the hospital for possible air contrast enema or ultrasound, as intussusception is a common cause of intestinal obstruction in this age group. Recurrence rates for intussusception are 5-10%.
Intussusception power point (3)
A 9 month old male presented with recurrent episodes of screaming and abdominal pain. On examination, the physician noted a sausage-shaped mass in the right upper quadrant of the abdomen. Imaging showed signs consistent with intussusception, including a target or crescent shape mass. The patient was given IV fluids and recommended for an air contrast enema to diagnose and potentially treat the suspected intussusception.
Intussusception
A 30-year-old female presented with acute left abdominal pain and nausea. Imaging showed an intussusception, which is when a segment of bowel invaginates into another segment, often causing obstruction. Intussusception is most common in children under 2 years old and is frequently idiopathic, while in adults it is often due to an underlying cause like tumors. Computed tomography is the most accurate way to diagnose intussusception based on its characteristic appearance.
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Intussusception
Intussusception is a condition where one part of the bowel slides into the next, blocking fluid and food passage and cutting off blood supply. It most commonly affects children under 2 years old. Symptoms include abdominal pain, vomiting, and bloody stools. Diagnosis is usually via ultrasound or enema x-ray. Treatment involves nonsurgical reduction via air or liquid enema or surgical reduction if complications are present. With treatment, prognosis is excellent though recurrence or complications can sometimes occur.
Large bowel obstruction -dr.p.saravanakumar ms pg tanjore medical college
This document discusses large bowel obstruction, including its classification, causes, pathogenesis, clinical features, investigations, and management. Large bowel obstruction can be classified depending on the nature, blood supply, presentation, and relation to the bowel lumen. The most common causes are colorectal cancer, colonic volvulus, and diverticulitis. Clinical features include abdominal distension, pain, constipation, and vomiting. Investigations include blood tests, imaging like CT, and endoscopy. Management involves resuscitation, decompression, surgery to resect non-viable bowel and anastomose or create a stoma, and treatment of underlying causes.
Intussusception in adults
Intussusception in adult population is quite uncommon. It is usually seen in the pediatric age group. A wide range of causes can predispose to intussusception in adults. Majority of them are benign especially in cases of small bowel intussusception. However malignancy is quite often encountered in cases of colonic intussusception. Diagnosis in adults is difficult due to vague symptoms and intermittent nature. Computerized tomography is diagnostic. However majority of cases in adults are diagnosed at laparotomy. Surgical resection assuming the lesion to be malignant is the treatment of choice.
Ultrasound and intussusception..One stop station for diagnosis and reduction
1) Ultrasound is a highly sensitive and specific tool for diagnosing intussusception, with typical signs including the target, doughnut, and sandwich signs.
2) Hydrostatic reduction of intussusception under ultrasound guidance has high success rates of 76-95% and a low risk of perforation compared to other methods.
3) The procedure involves inserting a Foley catheter and using saline under pressure to gradually reduce the intussusception while monitoring for signs of reduction or perforation under ultrasound. Multiple attempts over time may be used.
Presentation1.pptx, radiological imaging of intusussception.
This document discusses radiological imaging techniques for diagnosing and evaluating intussusception. It provides examples of how intussusception appears on plain abdominal x-rays, ultrasound scans, barium enemas, and CT scans. On CT scans, intussusception has a pathognomonic sausage-like or target-like appearance, with visible mesenteric fat and vessels. CT scanning is reported to have the highest diagnostic accuracy of 58-100% for intussusception. However, imaging cannot determine the underlying cause or extent of ischemic injury requiring surgery. The document shows various examples of intussusceptions appearing on CT scans in different regions of the bowel.
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Large bowel obstruction -dr.p.saravanakumar ms pg tanjore medical college
Large bowel obstruction -dr.p.saravanakumar ms pg tanjore medical college
Ultrasound and intussusception..One stop station for diagnosis and reduction
Ultrasound and intussusception..One stop station for diagnosis and reduction
Presentation1.pptx, radiological imaging of intusussception.
Presentation1.pptx, radiological imaging of intusussception.
Similar to Acute intussusception
Intestinal obstruction
This document discusses intestinal obstruction, including its causes, classifications, symptoms, diagnosis and treatment. Some key points:
- Intestinal obstruction can be caused by adhesions, hernias, tumors, strictures and more. It is classified by the obstructed site and presence of blood flow issues.
- Symptoms include pain, vomiting, constipation and distension. Signs depend on obstruction location and duration. Strangulated obstructions require urgent surgery to prevent tissue death.
- Diagnosis involves medical history, physical exam, imaging like x-rays and CT scans. Treatment involves resuscitation, nasogastric drainage, and surgery to relieve the obstruction and address the underlying cause. S
Hernias
A brief outline of classification of hernias, workup & management with a greater focus on the in-depth description of inguinal hernia.
Gastrointestinal Problems In Children
Intestinal duplications are rare congenital anomalies consisting of tubular or spherical structures attached to the intestine with a shared blood supply and intestinal lining. They are classified into 3 categories: localized duplications occurring anywhere in the gastrointestinal tract, duplications associated with spinal cord anomalies, and duplications of the colon associated with urinary/genital anomalies. Clinical manifestations include bowel obstruction, abdominal pain, and palpable masses. Diagnosis is based on history and physical exam. Treatment involves surgical resection and management of any associated defects.
Adhesions and bands
Intestinal obstruction can be caused by adhesions due to prior surgery or inflammation. Adhesions can be fibrinous and easy to remove early on, or fibrous and difficult to remove later. Treatment involves monitoring vitals, nasogastric decompression, IV fluids, and surgery if conservative measures fail or strangulation is suspected. During surgery, adhesions are lysed carefully to avoid further injury.
Gallstone ileus occurs when a gallstone erodes through the gallbladder and becomes lodged in the small intestine, causing obstruction. It typically affects elderly women and causes colicky pain, vomiting, and distension. Diagnosis is suggested by plain films showing pneumobilia and confirmed by CT
Adhesions and bands
Intestinal obstruction can be caused by adhesions due to prior surgery or inflammation. Adhesions can be fibrinous and easy to remove early on, or fibrous and difficult to remove later. Treatment involves monitoring vitals, nasogastric decompression, IV fluids, and surgery if conservative measures fail or strangulation is suspected. During surgery, adhesions are lysed carefully to avoid further injury.
Gallstone ileus occurs when a gallstone erodes through the gallbladder and becomes lodged in the small intestine, causing obstruction. It typically affects elderly women and causes colicky pain, vomiting, and distension. Diagnosis is suggested by plain films showing pneumobilia and confirmed by CT
GI obstructive condition -Intussusception.pptx
Intussusception is the telescoping of the proximal bowel into the distal bowel. It is most common in children under 2 years old, with the majority of cases being idiopathic. The classic triad of symptoms includes intermittent abdominal pain, a sausage-shaped abdominal mass, and bloody stools, though this triad is present in less than 15% of cases. Ultrasound is the preferred diagnostic tool, showing a target or doughnut-shaped mass. Treatment involves rehydration and stabilization, with non-operative reduction via hydrostatic or pneumatic enema being first-line for stable patients without evidence of perforation. Surgery is pursued if non-operative reduction fails or if there are signs of
intussusception.pptx
Intussusception is the telescoping of the proximal bowel into the distal bowel. It is most common in children under 2 years old and presents with intermittent abdominal pain, a palpable abdominal mass ("sausage-shaped"), and bloody stools. Ultrasound is the primary diagnostic tool, showing a target or doughnut sign. Treatment involves rehydration, antibiotics if infected, and non-operative reduction initially with air or barium enema. Surgery is needed if reduction fails or there is perforation with resection and anastomosis. Complications can include necrosis, perforation, sepsis but mortality is low (less than 1%) with prompt diagnosis and treatment.
Intussusception
Intussusception is the most common acute abdominal disorder of early childhood. In this lecture, we describe the manifests of Intussusception, the diagnosis, and the treatment of this disease.
Acquired intestinal ileus
This document discusses acquired intestinal ileus, which can be paralytic or mechanical in nature. Paralytic ileus is caused by medications, surgery, infection, or other insults and results in paralysis of intestinal movement. Mechanical obstruction can be caused by hernias, adhesions, tumors or other structural issues that physically block intestinal contents. Symptoms include abdominal pain, distension and inability to pass gas or stool. Diagnosis involves physical exam, imaging and labs. Treatment focuses on restoring bowel motility with decompression, fluids and electrolyte replacement. The document also discusses specific causes like intussusception, adhesions and their signs, symptoms, diagnosis and management.
Anorectal conditions
This document discusses the anatomy, clinical features, and management of various anorectal conditions including rectal prolapse, pilonidal disease, and perianal fistula. It begins with the anatomy of the rectum and anal canal. For rectal prolapse, it describes the types, risk factors, clinical features, and surgical management including procedures like Delormes and Altemeier's operation. Pilonidal disease and its pathogenesis, risk factors, clinical exam, and treatments are outlined. Perianal fistula is defined and the Goodsall rule, Park's classification system, investigations, and common surgical interventions like fistulotomy are summarized.
Bowel obstruction
This document discusses bowel obstruction, including classification, common causes, clinical features, investigations, and treatment. Bowel obstruction can be dynamic or mechanical, and is classified as partial or complete. Common causes include adhesions, hernias, volvulus, and tumors. Clinical features include colicky pain, vomiting, abdominal distension, and constipation. Investigations may include blood tests, abdominal x-rays, CT scans, and contrast studies. Treatment involves resuscitation, decompression, antibiotics, and surgery to remove the obstruction or affected bowel segment. Complications can include bleeding, infection, leakage, and recurrent obstruction.
DISEASES OF VULVA -BENIGN AND MALIGNANT
Vulval anatomy includes the mons pubis, labia majora, labia minora, clitoris, vestibule, and perineum. The vulva has both arterial and venous blood supply from branches of the internal pudendal and femoral arteries and veins. Innervation is from cutaneous branches of the ilioinguinal, genitofemoral, and pudendal nerves.
Common benign vulval disorders presented include Bartholin's cyst/abscess, sebaceous cysts, skin tags, lichen sclerosus, lichen planus, and non-neoplastic epithelial disorders. Bartholin's cysts occur near the vaginal opening and may
Benign gastric outlet obstruction
Benign gastric outlet obstruction can result from various benign conditions that cause mechanical impediment to gastric emptying. Peptic ulcer disease, particularly chronic ulcers, was previously a leading cause but has declined with treatment of Helicobacter pylori and use of proton pump inhibitors. Other benign causes include corrosive injury, certain drugs like NSAIDs, and inflammatory conditions of the stomach or duodenum. Patients present with epigastric pain, nausea, vomiting, and weight loss. Diagnosis involves imaging tests and endoscopy. Treatment depends on the underlying cause but may include endoscopic balloon dilation, surgery such as vagotomy and gastrojejunostomy, or management of the underlying disease in cases of inflammation. Complications can
Pediatric gi problems
Pediatric GI problems
Abdominal pain in children
DDx: Acute abdominal pain
Inflammatory:
• Abdominal infection: appendicitis, gastroenteritis, UTI, mesenteric adenitis (post URTI), mumps pancreatitis, hepatitis.
• Lower lobe pneumonia.
• Autoimmune: IBD, HSP, DKA.
Anatomical:
• GI obstruction, constipation.
• Meckel's complication e.g. obstruction, inflammation. However, Meckel's is usually asymptomatic.
• Renal and genitourinary: hydronephrosis, menstruation.
• Compressed anatomy: strangulated inguinal hernia, testis torsion.
Acute abdominal pain in children often has no specific cause ('non-specific abdominal pain'), and resolves in 24h.
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meckels, sigmoid, intussuception.pptx
1. Intussusception occurs when one part of the gut invaginates into an adjacent part, usually with the proximal loop entering the distal loop. It can be primary/idiopathic, seen commonly in children aged 6-9 months, or secondary due to underlying causes like polyps.
2. Clinical features include paroxysmal abdominal pain, vomiting, and passage of red currant jelly stools. Diagnosis is by ultrasound or CT scan. Treatment involves non-operative reduction via enema or surgery for cases where reduction is not possible.
3. Sigmoid volvulus occurs when the sigmoid colon twists around its axis, obstructing the lumen. It presents as large bowel obstruction
Gastroscope
Esophagogastroduodenoscopy (EGD) is an endoscopic examination of the esophagus, stomach, and duodenum used for both diagnostic and therapeutic purposes. It allows visualization of these areas as well as obtaining biopsies. Common indications include unexplained anemia, gastrointestinal bleeding, and dyspepsia. Potential complications are rare at 1 in 1000 and include aspiration pneumonia, bleeding, and perforation. Limitations include inability to fully examine gastrointestinal function or areas beyond the duodenum. Contraindications include recent heart issues or hypotension. Capsule endoscopy allows noninvasive imaging of the small intestine by using a swallowed capsule with a camera.
A Case of Chronic Diarrhoea
A 20-year-old girl presented with chronic diarrhea, fever, weight loss, and loss of appetite for 4 weeks. Colonoscopy and biopsy revealed diffuse large B-cell lymphoma of the duodenum and stomach. Imaging showed thickening and nodularity of the third part of the duodenum with enlarged lymph nodes. The patient was diagnosed with primary diffuse large B-cell lymphoma of the duodenum and stomach, stage II, and started on CHOP chemotherapy.
Peptic ulcer disease
This document discusses peptic ulcer disease, focusing on duodenal ulcers. It defines peptic ulcers and describes the pathogenesis, including protective and damaging factors. Helicobacter pylori infection plays a major role in ulcer development and the mechanisms by which it causes injury are explained. Diagnosis involves endoscopy, biopsy and testing for H. pylori. Treatment involves eradicating H. pylori with antibiotics and proton pump inhibitors. Complications of duodenal ulcers like bleeding and perforation are discussed. Bleeding ulcers are classified by the Forrest system and managed initially with endoscopic methods or surgery depending on severity. Perforated ulcers require surgical repair.
Common pediatric surgical conditions 2 By Dr Hatem El Gohary
This document discusses two common pediatric surgical conditions: intussusception and acute appendicitis. Intussusception occurs when one portion of the intestine invaginates into an adjacent segment, causing obstruction. It is usually ileocolic and can progress to gangrene. Acute appendicitis is inflammation of the appendix due to obstruction, and risks include poor localization and early perforation in pediatrics. Both conditions present with abdominal pain and require resuscitation, antibiotics, and sometimes surgery. Other causes of abdominal pain discussed include intestinal obstruction, constipation, urinary issues, and gastroenteritis.
Liver abscess in children
Pyogenic liver abscesses are rare in children, with 50% occurring in children under 6 years old. Risk factors include diabetes, underlying liver or pancreatic diseases, immunosuppression, and regular use of proton pump inhibitors. The most common causes are spread from intra-abdominal infections or bacteremia. Symptoms are non-specific but include fever, abdominal pain, and hepatomegaly. Ultrasound and CT scan can confirm the diagnosis. Treatment involves percutaneous or surgical drainage of pus combined with 4-6 weeks of antibiotics targeting likely pathogens. Prognosis has improved with early diagnosis and treatment but mortality can reach 12% if complications occur.
Similar to Acute intussusception (20)
Common pediatric surgical conditions 2 By Dr Hatem El Gohary
Common pediatric surgical conditions 2 By Dr Hatem El Gohary
Acute intussusception
- 1. Acute Intussusception Layout of talk Definition A etiology Pathology Clinical feature Deferential diagnosis Management
- 2. Definition: it is invagination of the gut within an .immediately adjacent sigment :A etiology Idiopathic about (70-95%) closed idiopathic- Associated with other illness such as Gastroenteritis- - Urinary tract infection - Adeno virus or Rota virus. - Adult causes associated with polyps ,submucosal lipoma .) and tumor (exception period of long fasting -
- 3. Pathology: Intussusception composed of three parts - the entering or inner tube - the returing or middle tube - the sheath or outer tube Intussusception it may anatomically defined as Ileoileal ileocaecal,and ileoolic depending on the side and extent of invagination
- 4. Clinical feature : abdominal pain - vomiting. -red current jelly stool :- EX Abdominal not distended ) A lump may be felt on palpation on (50-60% Felling of emptiness in the right iliac fossa Rectal examination blood stained mucos may be found on finger ,apex may palpable or even protrude from the anus in extensive ileo-colic .and colicolic
- 5. Radiological investigation: -plain abd x-ray --ileoileal or ileocolic -barium enema—ileocolic and colecolic .-c.t scan -ileoileal : Differential diagnosis Acute enterocolitis- Henoch schoenlein purpura- Rectal prolapse-
- 6. Management: - history -examination -investigation -treatment - follow up Treatment: non operative by hydrostatic reduction Contraindicated in obstruction, peritonitis , ).and prolong history (more than 48 hours Operative treatment when hydrostatic reduction failed or contraindicated