Peds emergency
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This document discusses several pediatric surgical conditions and emergencies. It provides details on fluid balance requirements in children, distinguishing hernias from hydroceles, managing testicular torsion as a surgical emergency, signs and symptoms of pyloric stenosis and intussusception, and features of malrotation on imaging. The key takeaway message is that children are the future and communities should promote resources to support child and family health.
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Tracheoesophageal Fistula
Esophageal atresia is a birth defect where the esophagus fails to form a connection to the stomach. It occurs in approximately 1 in 3,500 births. Types are classified based on connections between the esophagus and trachea. Clinical signs include excessive drooling, cyanosis during feeding, and abdominal distension. Diagnosis involves x-rays and catheter tests. Treatment involves stabilizing the newborn, stopping oral feeds, draining secretions, and surgical repair of the esophagus. Post-operative care focuses on airway clearance, nutrition via feeding tubes, and prevention of complications like pneumonia.
Common surgical problems in children
This document summarizes several common surgical problems in children. It discusses conditions like cleft lip and palate, gastroesophageal reflux disease, infantile hypertrophic pyloric stenosis, and Hirschsprung disease. For each condition, it provides information on incidence, clinical features, investigations, and management. The goal is to provide pediatricians with sound knowledge of these common pediatric surgical issues.
TEF PPT
This case presentation discusses a 3 day old male infant diagnosed with tracheoesophageal fistula (TEF). The infant presented with nasal flaring, difficulty breathing, choking and cyanosis since birth. Examination and investigations confirmed TEF, which was repaired surgically. Nursing management involved strict vital monitoring, ensuring nutrition via NG tube, preventing infection, and educating the family on post-operative care.
Tracheoesophageal fistula
A Tracheoesophageal fistula (TEF) is an abnormal connection (fistula) between the Oesophagus and the trachea. TEF is a common congenital abnormality.
Oesophageal atresia is failure of oesophagus to form a continuous passage from the pharynx to the stomach
TEF is an abnormal connection between the trachea and the oesophagus
Case study on Esophageal Atresia with Tracheo esophageal Fistula
This case study examines a 4-day-old female infant diagnosed with esophageal atresia with tracheo-esophageal fistula (EA/TEF) who was admitted to the surgical intensive care unit of Kanti Children's Hospital. The infant presented with excessive salivation, cyanosis after feeding, and difficulty breathing. Physical examination revealed decreased weight, dry skin, and abdominal distension. The patient was diagnosed with Type C EA/TEF, the most common type involving a blind proximal esophagus connected to the trachea by a fistula. Treatment involved surgical repair of the defect. The case study aims to provide a comprehensive overview of the patient's condition, including disease background, clinical presentation, management, and
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.
Approach to a vomiting Infant
This document discusses an approach to evaluating a vomiting infant, including potential causes of vomiting. It covers the relevant anatomy and embryology of the gastrointestinal tract. Specific conditions that can cause vomiting discussed include tracheo-esophageal fistulas, anorectal malformations, malrotation, intestinal atresia, Hirschsprung disease, and hypertrophic pyloric stenosis. The document aims to describe the diagnosis and management of vomiting in infants by understanding the potential anatomical abnormalities and applying the appropriate clinical approach and investigations.
Tracheoesophageal fistula
A 1 day old male infant was admitted to the NICU with excessive salivation and vomiting after breastfeeding. His symptoms worsened with feeding. Examination revealed no other abnormalities. X-ray studies including a dye study confirmed a provisional diagnosis of esophageal atresia and tracheoesophageal fistula made by the pediatric surgeon.
Recommended
Tracheoesophageal Fistula
Esophageal atresia is a birth defect where the esophagus fails to form a connection to the stomach. It occurs in approximately 1 in 3,500 births. Types are classified based on connections between the esophagus and trachea. Clinical signs include excessive drooling, cyanosis during feeding, and abdominal distension. Diagnosis involves x-rays and catheter tests. Treatment involves stabilizing the newborn, stopping oral feeds, draining secretions, and surgical repair of the esophagus. Post-operative care focuses on airway clearance, nutrition via feeding tubes, and prevention of complications like pneumonia.
Common surgical problems in children
This document summarizes several common surgical problems in children. It discusses conditions like cleft lip and palate, gastroesophageal reflux disease, infantile hypertrophic pyloric stenosis, and Hirschsprung disease. For each condition, it provides information on incidence, clinical features, investigations, and management. The goal is to provide pediatricians with sound knowledge of these common pediatric surgical issues.
TEF PPT
This case presentation discusses a 3 day old male infant diagnosed with tracheoesophageal fistula (TEF). The infant presented with nasal flaring, difficulty breathing, choking and cyanosis since birth. Examination and investigations confirmed TEF, which was repaired surgically. Nursing management involved strict vital monitoring, ensuring nutrition via NG tube, preventing infection, and educating the family on post-operative care.
Tracheoesophageal fistula
A Tracheoesophageal fistula (TEF) is an abnormal connection (fistula) between the Oesophagus and the trachea. TEF is a common congenital abnormality.
Oesophageal atresia is failure of oesophagus to form a continuous passage from the pharynx to the stomach
TEF is an abnormal connection between the trachea and the oesophagus
Case study on Esophageal Atresia with Tracheo esophageal Fistula
This case study examines a 4-day-old female infant diagnosed with esophageal atresia with tracheo-esophageal fistula (EA/TEF) who was admitted to the surgical intensive care unit of Kanti Children's Hospital. The infant presented with excessive salivation, cyanosis after feeding, and difficulty breathing. Physical examination revealed decreased weight, dry skin, and abdominal distension. The patient was diagnosed with Type C EA/TEF, the most common type involving a blind proximal esophagus connected to the trachea by a fistula. Treatment involved surgical repair of the defect. The case study aims to provide a comprehensive overview of the patient's condition, including disease background, clinical presentation, management, and
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.
Approach to a vomiting Infant
This document discusses an approach to evaluating a vomiting infant, including potential causes of vomiting. It covers the relevant anatomy and embryology of the gastrointestinal tract. Specific conditions that can cause vomiting discussed include tracheo-esophageal fistulas, anorectal malformations, malrotation, intestinal atresia, Hirschsprung disease, and hypertrophic pyloric stenosis. The document aims to describe the diagnosis and management of vomiting in infants by understanding the potential anatomical abnormalities and applying the appropriate clinical approach and investigations.
Tracheoesophageal fistula
A 1 day old male infant was admitted to the NICU with excessive salivation and vomiting after breastfeeding. His symptoms worsened with feeding. Examination revealed no other abnormalities. X-ray studies including a dye study confirmed a provisional diagnosis of esophageal atresia and tracheoesophageal fistula made by the pediatric surgeon.
Presentation1 (3)
Hypertrophic pyloric stenosis is a condition in infants where the muscle surrounding the pylorus (opening from the stomach to the small intestine) thickens, causing projectile vomiting after feeding. It most often affects young babies, especially boys. Surgery to cut the thickened pyloric muscle (pyloromyotomy) corrects the problem and stops the vomiting. With proper pre- and post-operative care including IV fluids, feeding, monitoring for complications, infants usually recover well after surgery.
Paediatric Gastroenterology
This document discusses two conditions that can cause bowel obstruction in children: Intussusception and Hirschsprung's disease. Intussusception occurs when the proximal bowel invaginates into the distal bowel, compressing and blocking it. It typically affects children from 2 months to 2 years and presents with severe abdominal pain, vomiting, and a palpable abdominal mass. Ultrasound can show the "target" or "doughnut sign". Treatment involves air or liquid enemas to try to reduce the intussusception or surgery if complications occur. Hirschsprung's disease is a congenital condition where the large bowel lacks ganglion cells, usually affecting the rectum. It presents in neonates
Pediatric surgery ppt 6th year
This document discusses pediatric surgery and focuses on congenital hypertrophic pyloric stenosis (CHPS). It describes CHPS as a condition that affects babies between birth and 6 months, causing forceful vomiting. The pathology involves hypertrophy of the pylorus muscle layer. Clinical features include projectile vomiting. Investigation may include ultrasound and barium meal. Treatment is resuscitation followed by Ramestedt pyloromyotomy surgery to cut the thickened pylorus muscle layer. Complications can include perforation or wound infection but recurrence is rare.
Vomiting in infants and children
This presentation describes the total and partial intestinal atresia, its clinical features and diagnosis. in addition, this presentation include the definition of esophageal atresia, its classification, diagnosis and treatment.
INFANTILE HYPERTROPHIC PYLORIC STENOSIS
Intestinal hypertrophic pyloric stenosis is a condition characterized by thickening of the pyloric muscle which obstructs the gastric outlet. It typically affects infants between 2-8 weeks of age, with males being affected more often than females. Surgical pyloromyotomy is the treatment of choice and involves cutting the thickened pyloric muscle to relieve the obstruction. If diagnosed and treated early, the prognosis is excellent with complete resolution and no risk of recurrence after surgery.
Common pediatric surgical conditions 3 Dr Hatem El Gohary
Hirschsprung disease is a developmental disorder of the enteric nervous system characterized by the absence of ganglion cells in the distal colon, resulting in functional obstruction. It is caused by congenital aganglionosis of the distal bowel. Diagnosis involves symptoms of delayed meconium passage and chronic constipation, as well as barium enema and rectal biopsy showing aganglionosis. Treatment involves rehydration, colostomy, and resection of the aganglionic segment via procedures like Swenson or Duhamel. Imperforate anus is caused by defects in formation of the posterior urorectal septum. It can be low or high and is sometimes associated with VACTERL
Case ihps
This document summarizes the case of a 1 month 18 day old male infant presenting with projectile vomiting for 7 days and abdominal distension for 3 days. On examination, the infant has a visible lump in the epigastrium. Based on examination findings and ultrasound results showing an elongated hypertrophic pylorus, the infant is diagnosed with infantile hypertrophic pyloric stenosis. He undergoes pyloromyotomy surgery and makes a good postoperative recovery.
Pyloric stenosis
Pyloric stenosis is a condition where the pylorus, the opening from the stomach to the small intestine, becomes narrowed due to muscle thickening. This causes projectile vomiting after feeding as food cannot pass easily into the intestines. It typically affects young infants under 3 months of age. Treatment involves a pyloromyotomy surgery to cut the thickened muscle and allow food to pass through.
Ultrasound in hypertropic pyloric stenosis
This document discusses infantile hypertrophic pyloric stenosis (IHPS), a condition that causes forceful vomiting in young infants. It provides details on the epidemiology, risk factors, clinical presentation, diagnosis and treatment of IHPS. Ultrasound is highlighted as the preferred method for diagnosing IHPS due to its non-invasive nature, accuracy and ability to directly visualize the thickened pyloric muscle. The document outlines the ultrasound technique and criteria used to diagnose IHPS based on measurements of the pyloric wall thickness and length.
Hypertropic pyloric stenosis
This document discusses hypertrophic pyloric stenosis, which causes projectile vomiting in infants. It is caused by muscle thickening around the pylorus, narrowing the gastric outlet. Risk factors include being male, firstborn, and certain ethnicities/blood types. While the exact cause is unknown, genetic and environmental factors play a role. Diagnosis involves physical exam and ultrasound finding thickened pyloric muscles. Treatment is pyloromyotomy surgery to divide the thickened muscles. Complications can include perforation or incomplete treatment of symptoms.
Intestinal obstruction
Intestinal obstruction occurs when there is an interruption of the normal passage of intestinal contents. It can be classified as mechanical or non-mechanical. Common causes of mechanical small bowel obstruction include adhesions, hernias, intussusceptions, and neoplasms. Common causes of mechanical large bowel obstruction are colon cancer, diverticular disease, and sigmoid volvulus. Diagnosis involves determining if obstruction is present and where, assessing for strangulation, and identifying the cause. Treatment depends on whether the obstruction is simple or there are signs of strangulation, and may involve decompression, IV fluids, or surgery.
Common pediatric surgical problems
The document discusses various pediatric gastrointestinal disorders including:
1. Duodenal atresia, malrotation with midgut volvulus, jejunal/ileal atresia as causes of intestinal obstruction.
2. Hirschsprung's disease, anorectal malformations, meconium ileus as other causes.
3. Signs, investigations, and management are described for different conditions like biliary atresia.
Pyloric stenosis
PYLORIC STENOSIS:
Review the anatomy and physiology of digestive system
Review the incidence of pyloric stenosis
Define pyloric stenosis
Explain the causes and risk factors of pyloric stenosis
Describe the pathophysiology of pyloric stenosis
Enumerate clinical features of pyloric stenosis
Enlist the diagnostic evaluation for pyloric stenosis
Explain the management of pyloric stenosis
Enumerate the complications of pyloric stenosis
Pyloric stenosis
Pyloric stenosis is a condition where the pylorus muscle becomes thickened, preventing food from exiting the stomach. It typically presents in infants in the first few months of life with projectile vomiting following feeding. Management involves initially trying smaller, more frequent feedings along with medications, and if that fails surgical pyloromyotomy is performed where the thickened pylorus muscle is incised to allow food passage.
Congenital hypertrophic pyloric stenosis
Congenital hypertrophic pyloric stenosis is a narrowing of the pylorus, the opening between the stomach and small intestine, caused by thickening of the pyloric muscles. It most commonly affects male infants between 2-8 weeks of age. Symptoms include projectile vomiting after feeding. Diagnosis is confirmed through imaging studies and physical exam finding an olive-sized mass. Surgical pyloromyotomy is the standard treatment, where the pyloric muscle is cut to widen the opening and relieve symptoms. Post-operative nursing care focuses on pain management, resuming feeding and monitoring for complications. With early diagnosis and treatment, prognosis is excellent.
GERD IN CHILDREN
This document discusses diagnosis and management of GERD in children. It defines GER and GERD, examines their epidemiology and prevalence in different pediatric populations. It explores the natural course of infant reflux and various etiological factors for GERD. Symptoms and complications of GERD in children are outlined. The relationship between GERD and asthma is examined, including how each condition may trigger the other. Diagnostic approaches and NASPGHAN guidelines for evaluating GERD in asthmatic children are presented.
Common pediatric surgery referrals
This document provides an overview of common referrals to pediatric surgery at Kentucky Children's Hospital. It discusses the top 10 most common referrals which include skin and soft tissue infections, hernias, head and neck masses, abdominal pain, pyloric stenosis, and undescended testicles. For each topic, it describes the scope of the problem, presentation, diagnosis, and treatment approaches used by the pediatric surgery specialists at the hospital. The goal is to help identify when a referral to pediatric surgery is appropriate.
IHPS
Rafin, a 40 day old male infant, presented with projectile vomiting since 17 days of age. Examination revealed a soft abdomen with an olive-sized mass palpable in the left upper quadrant. Imaging showed hypertrophy of the pyloric muscle, consistent with infantile hypertrophic pyloric stenosis. He was treated with intravenous fluids and electrolyte replacement. After correction of dehydration and electrolyte abnormalities, the patient was referred to pediatric surgery for pyloromyotomy to treat the underlying pyloric stenosis.
Tef ppt copy
Esophageal atresia is a failure of the esophagus to fully develop during gestation, resulting in abnormal connections between the trachea and esophagus. It occurs during the 4th-5th week of gestation due to abnormalities in the septum that separates the esophagus and trachea. Clinical features include excessive drooling, coughing, choking, and cyanosis during feeding. Diagnosis involves tests like x-ray and endoscopy to detect the abnormal connections. Initial management focuses on nothing by mouth and nasogastric decompression to prevent aspiration. Definitive treatment is surgical repair of the connections once the infant is stable. Long term complications can include strictures requiring dilation.
Approach to Vomiting in children
This document provides guidance on evaluating and treating a child presenting with vomiting. It begins with definitions of related terms like nausea, retching, and regurgitation. It then reviews the major neurophysiological pathways that can induce vomiting. Etiologies are discussed including central, infectious, metabolic, and peripheral causes. An approach is outlined involving obtaining a thorough history and physical exam to determine potential causes and guide testing. Common etiologies are reviewed for different age groups. Complications, treatment principles targeting the underlying cause, and sick day management for diabetes are also summarized.
Case Study: Diaphragm Eventration with differtials
Mr. Saber, a 50-year-old male, presented with a 4-5 day history of cough and intermittent shortness of breath. CT scan revealed an elevated left hemidiaphragm with no other abnormalities. The most probable diagnosis is diaphragmatic eventration, which is a congenital thinning of the diaphragm muscle. Diaphragmatic eventration is usually asymptomatic but can cause breathing difficulties. Differential diagnoses for an elevated hemidiaphragm include phrenic nerve palsy, lung issues, pleural diseases, hernias, tumors, trauma, and abdominal causes. A thorough evaluation is needed to determine the underlying cause.
Evaluation of proteinuria in children - by Dr.B.Sivakanth
1) Proteinuria, or excess protein in the urine, is a common finding in children that requires evaluation to determine the cause. Transient or orthostatic proteinuria are generally benign, while persistent proteinuria may indicate kidney disease.
2) Evaluation of a child with proteinuria includes a history, physical exam, urinalysis, and tests to assess kidney function. Distinguishing transient, orthostatic, and persistent proteinuria guides further testing and management.
3) For persistent proteinuria, additional tests are needed to identify potential causes like glomerular disease, tubular disorders, or infection and determine if nephrology referral is required. Ongoing monitoring is important to classify the
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Presentation1 (3)
Hypertrophic pyloric stenosis is a condition in infants where the muscle surrounding the pylorus (opening from the stomach to the small intestine) thickens, causing projectile vomiting after feeding. It most often affects young babies, especially boys. Surgery to cut the thickened pyloric muscle (pyloromyotomy) corrects the problem and stops the vomiting. With proper pre- and post-operative care including IV fluids, feeding, monitoring for complications, infants usually recover well after surgery.
Paediatric Gastroenterology
This document discusses two conditions that can cause bowel obstruction in children: Intussusception and Hirschsprung's disease. Intussusception occurs when the proximal bowel invaginates into the distal bowel, compressing and blocking it. It typically affects children from 2 months to 2 years and presents with severe abdominal pain, vomiting, and a palpable abdominal mass. Ultrasound can show the "target" or "doughnut sign". Treatment involves air or liquid enemas to try to reduce the intussusception or surgery if complications occur. Hirschsprung's disease is a congenital condition where the large bowel lacks ganglion cells, usually affecting the rectum. It presents in neonates
Pediatric surgery ppt 6th year
This document discusses pediatric surgery and focuses on congenital hypertrophic pyloric stenosis (CHPS). It describes CHPS as a condition that affects babies between birth and 6 months, causing forceful vomiting. The pathology involves hypertrophy of the pylorus muscle layer. Clinical features include projectile vomiting. Investigation may include ultrasound and barium meal. Treatment is resuscitation followed by Ramestedt pyloromyotomy surgery to cut the thickened pylorus muscle layer. Complications can include perforation or wound infection but recurrence is rare.
Vomiting in infants and children
This presentation describes the total and partial intestinal atresia, its clinical features and diagnosis. in addition, this presentation include the definition of esophageal atresia, its classification, diagnosis and treatment.
INFANTILE HYPERTROPHIC PYLORIC STENOSIS
Intestinal hypertrophic pyloric stenosis is a condition characterized by thickening of the pyloric muscle which obstructs the gastric outlet. It typically affects infants between 2-8 weeks of age, with males being affected more often than females. Surgical pyloromyotomy is the treatment of choice and involves cutting the thickened pyloric muscle to relieve the obstruction. If diagnosed and treated early, the prognosis is excellent with complete resolution and no risk of recurrence after surgery.
Common pediatric surgical conditions 3 Dr Hatem El Gohary
Hirschsprung disease is a developmental disorder of the enteric nervous system characterized by the absence of ganglion cells in the distal colon, resulting in functional obstruction. It is caused by congenital aganglionosis of the distal bowel. Diagnosis involves symptoms of delayed meconium passage and chronic constipation, as well as barium enema and rectal biopsy showing aganglionosis. Treatment involves rehydration, colostomy, and resection of the aganglionic segment via procedures like Swenson or Duhamel. Imperforate anus is caused by defects in formation of the posterior urorectal septum. It can be low or high and is sometimes associated with VACTERL
Case ihps
This document summarizes the case of a 1 month 18 day old male infant presenting with projectile vomiting for 7 days and abdominal distension for 3 days. On examination, the infant has a visible lump in the epigastrium. Based on examination findings and ultrasound results showing an elongated hypertrophic pylorus, the infant is diagnosed with infantile hypertrophic pyloric stenosis. He undergoes pyloromyotomy surgery and makes a good postoperative recovery.
Pyloric stenosis
Pyloric stenosis is a condition where the pylorus, the opening from the stomach to the small intestine, becomes narrowed due to muscle thickening. This causes projectile vomiting after feeding as food cannot pass easily into the intestines. It typically affects young infants under 3 months of age. Treatment involves a pyloromyotomy surgery to cut the thickened muscle and allow food to pass through.
Ultrasound in hypertropic pyloric stenosis
This document discusses infantile hypertrophic pyloric stenosis (IHPS), a condition that causes forceful vomiting in young infants. It provides details on the epidemiology, risk factors, clinical presentation, diagnosis and treatment of IHPS. Ultrasound is highlighted as the preferred method for diagnosing IHPS due to its non-invasive nature, accuracy and ability to directly visualize the thickened pyloric muscle. The document outlines the ultrasound technique and criteria used to diagnose IHPS based on measurements of the pyloric wall thickness and length.
Hypertropic pyloric stenosis
This document discusses hypertrophic pyloric stenosis, which causes projectile vomiting in infants. It is caused by muscle thickening around the pylorus, narrowing the gastric outlet. Risk factors include being male, firstborn, and certain ethnicities/blood types. While the exact cause is unknown, genetic and environmental factors play a role. Diagnosis involves physical exam and ultrasound finding thickened pyloric muscles. Treatment is pyloromyotomy surgery to divide the thickened muscles. Complications can include perforation or incomplete treatment of symptoms.
Intestinal obstruction
Intestinal obstruction occurs when there is an interruption of the normal passage of intestinal contents. It can be classified as mechanical or non-mechanical. Common causes of mechanical small bowel obstruction include adhesions, hernias, intussusceptions, and neoplasms. Common causes of mechanical large bowel obstruction are colon cancer, diverticular disease, and sigmoid volvulus. Diagnosis involves determining if obstruction is present and where, assessing for strangulation, and identifying the cause. Treatment depends on whether the obstruction is simple or there are signs of strangulation, and may involve decompression, IV fluids, or surgery.
Common pediatric surgical problems
The document discusses various pediatric gastrointestinal disorders including:
1. Duodenal atresia, malrotation with midgut volvulus, jejunal/ileal atresia as causes of intestinal obstruction.
2. Hirschsprung's disease, anorectal malformations, meconium ileus as other causes.
3. Signs, investigations, and management are described for different conditions like biliary atresia.
Pyloric stenosis
PYLORIC STENOSIS:
Review the anatomy and physiology of digestive system
Review the incidence of pyloric stenosis
Define pyloric stenosis
Explain the causes and risk factors of pyloric stenosis
Describe the pathophysiology of pyloric stenosis
Enumerate clinical features of pyloric stenosis
Enlist the diagnostic evaluation for pyloric stenosis
Explain the management of pyloric stenosis
Enumerate the complications of pyloric stenosis
Pyloric stenosis
Pyloric stenosis is a condition where the pylorus muscle becomes thickened, preventing food from exiting the stomach. It typically presents in infants in the first few months of life with projectile vomiting following feeding. Management involves initially trying smaller, more frequent feedings along with medications, and if that fails surgical pyloromyotomy is performed where the thickened pylorus muscle is incised to allow food passage.
Congenital hypertrophic pyloric stenosis
Congenital hypertrophic pyloric stenosis is a narrowing of the pylorus, the opening between the stomach and small intestine, caused by thickening of the pyloric muscles. It most commonly affects male infants between 2-8 weeks of age. Symptoms include projectile vomiting after feeding. Diagnosis is confirmed through imaging studies and physical exam finding an olive-sized mass. Surgical pyloromyotomy is the standard treatment, where the pyloric muscle is cut to widen the opening and relieve symptoms. Post-operative nursing care focuses on pain management, resuming feeding and monitoring for complications. With early diagnosis and treatment, prognosis is excellent.
GERD IN CHILDREN
This document discusses diagnosis and management of GERD in children. It defines GER and GERD, examines their epidemiology and prevalence in different pediatric populations. It explores the natural course of infant reflux and various etiological factors for GERD. Symptoms and complications of GERD in children are outlined. The relationship between GERD and asthma is examined, including how each condition may trigger the other. Diagnostic approaches and NASPGHAN guidelines for evaluating GERD in asthmatic children are presented.
Common pediatric surgery referrals
This document provides an overview of common referrals to pediatric surgery at Kentucky Children's Hospital. It discusses the top 10 most common referrals which include skin and soft tissue infections, hernias, head and neck masses, abdominal pain, pyloric stenosis, and undescended testicles. For each topic, it describes the scope of the problem, presentation, diagnosis, and treatment approaches used by the pediatric surgery specialists at the hospital. The goal is to help identify when a referral to pediatric surgery is appropriate.
IHPS
Rafin, a 40 day old male infant, presented with projectile vomiting since 17 days of age. Examination revealed a soft abdomen with an olive-sized mass palpable in the left upper quadrant. Imaging showed hypertrophy of the pyloric muscle, consistent with infantile hypertrophic pyloric stenosis. He was treated with intravenous fluids and electrolyte replacement. After correction of dehydration and electrolyte abnormalities, the patient was referred to pediatric surgery for pyloromyotomy to treat the underlying pyloric stenosis.
Tef ppt copy
Esophageal atresia is a failure of the esophagus to fully develop during gestation, resulting in abnormal connections between the trachea and esophagus. It occurs during the 4th-5th week of gestation due to abnormalities in the septum that separates the esophagus and trachea. Clinical features include excessive drooling, coughing, choking, and cyanosis during feeding. Diagnosis involves tests like x-ray and endoscopy to detect the abnormal connections. Initial management focuses on nothing by mouth and nasogastric decompression to prevent aspiration. Definitive treatment is surgical repair of the connections once the infant is stable. Long term complications can include strictures requiring dilation.
Approach to Vomiting in children
This document provides guidance on evaluating and treating a child presenting with vomiting. It begins with definitions of related terms like nausea, retching, and regurgitation. It then reviews the major neurophysiological pathways that can induce vomiting. Etiologies are discussed including central, infectious, metabolic, and peripheral causes. An approach is outlined involving obtaining a thorough history and physical exam to determine potential causes and guide testing. Common etiologies are reviewed for different age groups. Complications, treatment principles targeting the underlying cause, and sick day management for diabetes are also summarized.
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Common pediatric surgical conditions 3 Dr Hatem El Gohary
Common pediatric surgical conditions 3 Dr Hatem El Gohary
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Case Study: Diaphragm Eventration with differtials
Mr. Saber, a 50-year-old male, presented with a 4-5 day history of cough and intermittent shortness of breath. CT scan revealed an elevated left hemidiaphragm with no other abnormalities. The most probable diagnosis is diaphragmatic eventration, which is a congenital thinning of the diaphragm muscle. Diaphragmatic eventration is usually asymptomatic but can cause breathing difficulties. Differential diagnoses for an elevated hemidiaphragm include phrenic nerve palsy, lung issues, pleural diseases, hernias, tumors, trauma, and abdominal causes. A thorough evaluation is needed to determine the underlying cause.
Evaluation of proteinuria in children - by Dr.B.Sivakanth
1) Proteinuria, or excess protein in the urine, is a common finding in children that requires evaluation to determine the cause. Transient or orthostatic proteinuria are generally benign, while persistent proteinuria may indicate kidney disease.
2) Evaluation of a child with proteinuria includes a history, physical exam, urinalysis, and tests to assess kidney function. Distinguishing transient, orthostatic, and persistent proteinuria guides further testing and management.
3) For persistent proteinuria, additional tests are needed to identify potential causes like glomerular disease, tubular disorders, or infection and determine if nephrology referral is required. Ongoing monitoring is important to classify the
Surgical emergencies in newborn
This document summarizes several common surgical disorders that can occur in newborns, including fetal surgical disorders like polyhydramnios and oligohydramnios, as well as postnatal disorders involving the respiratory, gastrointestinal, and genitourinary systems. Key conditions discussed include esophageal atresia, tracheoesophageal fistula, diaphragmatic hernia, anorectal malformations, and necrotizing enterocolitis. Diagnostic approaches and management strategies are provided for each condition.
Pediatric Surgery spectrum
Probably Pediatric Surgery is the only surgical specialty which opens all four body cavities to treat their little patients. This is a pictorial glimpse of the wide spectrum of Pediatric Surgery.
Hirschprung disease by dr manzoor
Hirschsprung disease, also known as congenital aganglionic megacolon, is a developmental disorder of the enteric nervous system where a section of the bowel starting at the anus lacks ganglion cells. This causes bowel obstruction and an enlargement of the colon. It occurs in about 1 in 5000 live births and is most common in males. Diagnosis involves biopsy of the narrowed segment showing absence of ganglion cells. Treatment is surgical removal of the abnormal section followed by reanastomosis.
Pediatric surgery (1)
William E. Ladd is considered the father of pediatric surgery, graduating from Harvard University in 1902 and Harvard Medical School in 1906. To become a pediatric surgeon requires 4 years of college, 4 years of medical school, and 3 years of pediatric residency training for a total of 11-12 years of education. Pediatric surgeons typically earn $400,000-$500,000 annually or approximately $80 per hour.
Tracheo Esophageal Fistula and Anesthesia
The document discusses tracheo-esophageal fistula, a birth defect where the trachea and esophagus are connected by an abnormal passageway. It describes the embryology, classification, clinical presentation including signs, anesthetic considerations for repair surgery, surgical repair techniques including conventional open and endoscopic methods, risks, and postoperative care. The prognosis is guarded as recurrent fistulas and long-term complications like esophageal stricture and lung disease are common.
Pediatric Cardiology Emergencies
The document discusses several pediatric cardiology emergencies including newborn problems presenting as cyanosis or low cardiac output. Cyanosis may be caused by right-sided obstructive lesions, abnormal circulations, or left-sided obstructive lesions. Treatment involves prostaglandins, restoring acid-base balance, and surgery. Low cardiac output can be caused by muscle diseases, heart rate problems, or left-sided obstructive lesions. Other issues discussed include hypercyanotic spells in infants/children with tetralogy of Fallot or pulmonary atresia, congestive heart failure, and arrhythmias including supraventricular tachycardia.
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Tracheo-oesophageal fistula and oesophagal atresia are birth defects where the esophagus does not form properly, either failing to connect to the stomach or connecting abnormally to the trachea. They occur in about 1 in 3500 births. Surgical intervention is required to divide any abnormal connections or perform anastomosis to reconnect the esophagus. Nursing care focuses on preventing aspiration, maintaining nutrition via feeding tubes, and managing pain and comfort after surgery. Complications can include tracheomalacia, anastomotic leaks, strictures, and reflux.
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Brief description about Esophageal Atresia & Tracheo-Esophageal Fistula: embryology, surgical history and management of Type 2: EA & Distal TEF.
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1. The document provides an overview of common pediatric surgical conditions, including congenital diaphragmatic hernia, esophageal atresia with tracheoesophageal fistula, congenital hypertrophic pyloric stenosis, intussusception, Meckel's diverticulum, Hirschsprung disease, and anorectal malformations.
2. It describes the definition, etiology, pathophysiology, clinical presentation, diagnostic workup, and management of each condition. Diagrams and images are provided to illustrate key aspects.
3. The review is intended for 6th year medical students to familiarize them with important pediatric surgical topics.
Paediatric Emergencies
This document outlines various pediatric emergencies including coma, shock, respiratory emergencies like croup and asthma, infections like meningitis, seizures, and other conditions. It provides assessments and management guidelines for these conditions, with specific details on vital signs, investigations, medications and criteria for admission or transfer to ICU.
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Similar to Peds emergency
10. ac. diarrhoea, vomiting & rec abd pain
Diarrhea is defined as 3 or more loose stools per day. It is a major cause of morbidity and mortality in children in developing countries. There are different types of diarrhea including acute and chronic. Common causes of acute diarrhea include gastroenteritis, food poisoning, and antibiotics. Chronic diarrhea has causes such as lactose intolerance and inflammatory bowel disease. Assessment of diarrhea involves history, physical exam, and testing to identify dehydration and the underlying cause. Management depends on the degree of dehydration and may include oral rehydration, IV fluids, and antibiotics for severe cases.
BED-12 kuliah BA 2011 - Copy.ppt
Neonatal surgical problems often present as emergencies and require rapid stabilization and transfer. Proper initial management is crucial, as neonatal and pediatric patients frequently have multi-organ system involvement. Common emergency cases include esophageal atresia, congenital diaphragmatic hernia, intestinal obstruction, inguinal hernia, and necrotizing enterocolitis. Initial management focuses on airway control, oxygenation, intravenous access, and thermoregulation to optimize the patient's condition for urgent or emergent surgery.
DEVELOPMENT OF GIT AND CONGENITAL ANOMALIES OF GIT
GASTROINTESTINAL TRACT DEVELOPMENT , CONGENITAL MALFORMATIONS , ANOMALIES , GERD , NELSON , PEDIATRICS , NELSON
Pyloric stenosis.pptx
Introduction
• Pyloric stenosis is also known as pylorostenosis or infantile hypertrophic pyloric stenosis. It is the most common cause of intestinal obstruction in infants. It is a form of obstruction in the gastric outlet which means a blockage from stomach to intestine.
• It was First described by Hirschsprung in 1888
• Ramstedt described an operative procedure to alleviate the condition in 1907 – the procedure used to this day to treat pyloric stenosis.
Definition
• Hypertrophic pyloric stenosis is a marked and progressive outgrowth or enlargement of circular muscle fibers of pylorus causing partial or total obstruction of the stomach outlet due to narrowing of lumen.
Anatomy
The stomach sits in the upper abdomen on left side of the body. The top of the stomach connects to a valve called the esophageal sphincter (a muscle at the end of esophagus). The bottom of stomach connects to small intestine.
The stomach is divided into 5 regions:
• The cardia is the top part of the stomach. It contains the cardiac sphincter, which prevents food from traveling back up the esophagus.
• The fundus is a rounded section next to the cardia. It's below the diaphragm (the dome-shaped muscle that helps to breathe).
• The body (corpus) is the largest section of the stomach. In the body, stomach contracts and begins to mix food.
• The antrum lies below the body. It holds food until the stomach is ready to send it to your small intestine.
• The pylorus is the bottom part of the stomach. It includes the pyloric sphincter. This ring of tissue controls when and how stomach contents move to the small intestine.
Incidence
• It is more commonly seen in child with 2-5wks of age.
• 2-9 per 1000 livebirths can be born with this condition.
• Predominant sex: Male > Female (6:1). Males are more prone to get
• Genetic predisposition can be an underlying factor for disease causation.
• Full term babies especially first borne are most commonly affected.
• Death from infantile hypertrophic pyloric stenosis is rare and unexpected; the reported mortality rate is very low and usually results from delays in diagnosis with eventual dehydration and shock.
Etiology
• Idiopathic
• Other factors : *maternal stress especially in third trimester *elevated prostaglandin levels *deficiency of nitric acid *immature pyloric ganglion cells with abnormal muscle innervation.
• In adults, it can occur due to history of peptic ulcer in pylorus region and hypertrophic changes in muscle layer of pylorus.
Risk factors
• Sex. Pyloric stenosis is seen more often in boys — especially firstborn children — than in girls.
• Race. Pyloric stenosis is more common in whites of northern European ancestry, less common in Black people and rare in Asian
Neonatal intestinal obstruction
Delayed passage of meconium can be caused by several intestinal obstructions and diseases. It is suspected in full-term infants who do not pass meconium in the first 24 hours and in premature infants who delay passage for over a week. Diagnostic workup includes abdominal x-rays, ultrasound, and contrast studies to locate the obstruction. Management requires gastric decompression, fluid resuscitation to address dehydration, and monitoring of electrolytes and glucose levels which may become imbalanced. The cause is determined based on the presentation and imaging findings, and treatment involves surgery for structural issues or supportive care for medical conditions.
Megacolon Disease in Children
Hirschsprung's disease is a birth defect where parts of the intestine do not have nerve cells. This causes poor or no muscle movement in the affected area. The document discusses the causes, symptoms, tests used for diagnosis, surgical treatments like colostomy and resection of the affected bowel, potential complications, nursing care before and after surgery, and long-term prognosis. The key surgical procedures mentioned are Swenson's procedure, Duhamel's procedure and Soave's procedure.
common surgical problem in pediatrics done.pptx
This document discusses several common surgical problems in children. It begins by explaining the need for pediatricians to have knowledge of these conditions. It then lists and provides brief overviews of various issues such as cleft lip/palate, gastroesophageal reflux disease, Hirschsprung's disease, intestinal malformations, hernias, and genitourinary problems. For several conditions, it describes symptoms, investigations, management, and associated abnormalities. Throughout, it includes diagrams and images to illustrate key points.
Anaesthesia challenges in neonatal emergencies-1.pptx
Neonatal emergencies present unique challenges in anesthesia, requiring specialized knowledge and skills to ensure safe and effective care for these vulnerable patients. This presentation delves into the intricacies of providing anesthesia to neonates in emergency situations, discussing physiological differences, equipment considerations, medication dosages, and monitoring techniques tailored to this population. Explore essential strategies and best practices for managing airway, ventilation, and hemodynamic stability in neonatal emergencies, aiming to optimize outcomes and mitigate risks. Whether you're a seasoned anesthesiologist or a healthcare professional seeking insight into neonatal anesthesia, this presentation offers valuable insights into navigating the complexities of neonatal emergencies with confidence and expertise.
Parasitic infestations of the biliary tract
Fascioliasis is caused by the liver fluke Fasciola hepatica. It has a complex life cycle involving freshwater snails and aquatic plants. Infection causes acute and chronic symptoms from larval migration and adult fluke presence in the biliary tract. Diagnosis involves serology, stool exams, imaging. Triclabendazole is treatment. Biliary ascariasis occurs when the roundworm Ascaris lumbricoides enters the biliary tract, potentially causing pain, cholangitis, or pancreatitis. It is diagnosed via imaging, stool/blood tests and treated with antihelminthics or endoscopic/surgical removal of worms.
intestinal obstruction.pptx
In these slides we will go through the surgical anatomy of the gut,pathophysiology of intestinal obstruction, clinical presentation and management. Also we will discuss specific types of intestinal obstruction.
The basics of peds anesthesia [autosaved]
This document provides an overview of key differences in pediatric anesthesia compared to adult anesthesia. It discusses how pediatric patients have different anatomy, physiology, pharmacology, and psychology compared to adults. Some key points summarized are:
1. Pediatric patients have proportionally larger head size, smaller lung volumes, higher heart rates, and different responses to drugs due to immature organ systems.
2. Anesthesia risks for children include higher risks of respiratory issues, hypothermia, hypotension, and emergence delirium compared to adults.
3. Proper fluid management is important due to differences in kidney function and risk of dehydration in pediatric patients.
Physiological changes in pregnancy
Physiological changes in pregnancy. It includes changes in the genital organs, uterus, cardiovascular changes, respiratory, metabolic, alimentary, skin, skeleton, psychological changes, urinary changes and weight gain in pregnancy.
Nursing management of genito urinary disorders in children
This document provides information on nursing management for genitourinary surgeries in children. It discusses conditions like hydronephrosis, pelviureteric junction obstruction (PUJO), vesicoureteral reflux (VUR), and posterior urethral valves (PUV). For PUJO, it outlines the preoperative, operative, and postoperative nursing management including assessments, interventions for complications, and patient/family education. It also discusses VUR including clinical presentation, treatment options of medical management, surgical correction, and conservative management with antibiotic prophylaxis.
diarrhoea-181206143057.pptx
This document provides an overview of diarrhea, including its definition, causes, clinical features, diagnosis, evaluation of dehydration, treatment and prevention. It discusses acute, prolonged and persistent diarrhea. Key points include:
- Diarrhea is defined as excessive loss of fluid and electrolytes in stool. It can be caused by infections, malabsorption, medications and other conditions.
- Clinical features may indicate specific causes, such as bloody stools suggesting bacteria. Dehydration is evaluated through physical exam findings.
- Treatment involves oral rehydration with fluids and zinc supplementation. Severe dehydration requires intravenous fluids. Continued feeding is important.
- Prevention focuses on good hygiene, vaccines
childhood intestinal obstruction.pptx
This document discusses several common causes of childhood intestinal obstruction including:
1. Rotation defects that can cause midgut volvulus like malrotation or incomplete rotation.
2. Duodenal atresia which presents with jaundice and bilious vomiting in newborns.
3. Meconium ileus which is thick meconium causing ileal obstruction in cystic fibrosis patients.
4. Congenital hypertrophic pyloric stenosis causing projectile vomiting in infants.
5. Intussusception where one segment of bowel slides into another causing obstruction.
6. Hirschsprung disease where absence of ganglion cells in a segment of colon causes constipation.
Anesthetic consideration anorectal malformation
1) Anorectal malformations are congenital abnormalities of the rectum and anus that occur due to imperfect fusion during development in utero. They can range from minor stenoses to more severe high abnormalities involving the bladder or genital tract.
2) It is important to determine if the abnormality is high or low through investigations like invertograms in order to plan appropriate treatment. Associated abnormalities in other organ systems must also be ruled out.
3) For anesthesia, special consideration is given to temperature control, ventilation, and careful monitoring due to the vulnerability of infants with anorectal malformations. Regional techniques or low-dose inhalational inductions are preferred.
ACUTE PEDIATRIC GASTROENTERITIS
This document provides information on acute pediatric gastroenteritis. It defines gastroenteritis and discusses its main causes such as rotavirus, norovirus, and various bacteria. Signs and symptoms include diarrhea, vomiting, fever and dehydration. Management involves oral rehydration with WHO oral rehydration solution. For severe dehydration, intravenous fluids are used. Antibiotics generally are not needed unless for specific infections. Probiotics and zinc supplementation may shorten the duration of diarrhea.
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Peds emergency
- 1. DR. ZAINAB AL BALUSHI MD,FRCSC, FICS SENIOR CONSULTANT PEDIATRIC SURGERY SULTAN QABOOS UNIVERSITY HOSPITAL,OMAN Paediatric Surgery Emergencies
- 3. Larger surface area to mass ratio Less SQ fat More body water Higher metabolic rate Thermoregulation
- 4. FLUID BALANCE Maintenance Fluid Requirement: 0 –10 Kg ---> 4 ml/Kg/hr 10 –20 Kg ---> 2ml/Kg/hr 20+ Kg ---> 1 ml/Kg/hr Adequate urine output: 1 –2 mls/Kg/hour Circulating volume:85 ml/kg
- 10. Thyroglossal Duct Cyst / Dermoid Midline neck masses Both require excision TGDC can become infected (rare for Dermoids)
- 12. Groin conditions
- 13. Hernia or Hydrocele? Both due to patent processus vaginalis �Hydroceles: transilluminate palpate the cord above it often can’t feel the testis �Hernias: can be reduced painful if incarcerated
- 17. In a female consider the possibility of an incarcerated ovary
- 19. Acute Scrotum
- 20. Testicular torsion Twisting of testis around spermatic cord Caused by abnormal fixation of testis to scrotum Vascular supply compromised Acute painful scrotal swelling Severe tenderness Redness or dusky color Testis elevated Cremasteric reflex absent !SURGICAL EMERGENCY
- 21. Torsion R. testis: blood flow (Doppler) L. testis: lack of blood flow The consequence of delayed diagnosis 6 hour window for surgical detorsion
- 22. Management Immediate surgical consultation is essential . Surgical exploration , detorsion and fixation.
- 24. PYLORIC STENOSIS •Male:Female 4:1 •Age 2 –6 weeks •Forceful nonbilious vomiting (“projectile”) •Dx: Palpation of mass Ultrasound UGI contrast study
- 25. Diagnosis UGI Delayed passage of barium through thickened pyloric channel Ultrasound Thickened, elongated pyloric channel
- 26. Resuscitation Correction of dehydration Correction of Hypochloremic metabolic alkalosis Ramstedt Pyloromyotomy
- 27. INTUSSUSCEPTION Age 2 months to 2 years Recent viral illness Intermittent severe visceral pain (cramps) Blood PR => Currant jelly stool Eventually will develop a distal bowel obstruction
- 29. Donut sign
- 30. Contrast Enema
- 32. BEWARE THE BABY WHO VOMITS BILE !!!!
- 33. MALROTATION / VOLVULUS Malrotation leads to nonfixation of the bowel, which predisposes to volvulus Arrest of rotation after 90 degrees (270 normal) 1st yr of life
- 38. Transition Zone
- 39. In Summary Do not incise Peri-anal abscess in neonate Do not confuse Infected Thyroglossal cyst with Neck abscess Do not miss acute scrotal conditions Bilious vomiting is always serious in children
- 40. Take home message Children are the heart and best resource of our future. So, Let us try our best to develop and promote innovative and sustainable community resources that nurture healthy children, healthy families and healthy communities.
- 41. Thanks