paediatric general surgery (1) juan bass md frcsc

PAEDIATRIC GENERAL SURGERY (1)

JUAN BASS MD FRCSC

PEDIATRIC SURGICAL REVIEW

PYLORIC STENOSIS INTUSSUSCEPTION MALROTATION SMALL BOWEL OBSTRUCTION APPENDICITIS- MECKEL’S

PEDIATRIC SURGICAL REVIEW

ESOPHAGEAL ATRESIA CONGENITAL DIAPHRAGMATIC

HERNIA

PEDIATRIC SURGICAL REVIEW

INGUINOSCROTAL PATHOLOGIES: HYDROCELE HERNIA TESTICULAR TORSION VARICOCELE

PYLORIC STENOSIS

NON BILIOUS VOMITINGPROGRESSIVE…..PROJECTILE

DIFFERENTIAL DIAGNOSIS

PYLORIC STENOSIS FEEDING INTOLERANCE G.E. REFLUX INFECTIONS

UTI CNS GI

HYDRATION

FONTANELLE EYES MUCOUS MEMBRANES SKIN TURGOR URINARY OUTPUT

ABDOMINAL EXAMINATION

GASTRIC DISTENTION GASTRIC PERISTALTIC WAVES PYLORIC OLIVE

PRIORITIES

REHYDRATION CORRECTION OF ELECTROLYTE

AND METABOLIC ABNORMALITIES CONFIRM DIAGNOSIS

METABOLIC ALKALOSIS HYPOCHLOREMIA HYPOKALEMIA

RENAL LOSS

ULTRASOUND

PYLOROMYOTOMY

REHYDRATEDNORMAL ELECTROLYTESALKALOSIS CORRECTED

INTUSSUSCEPTION

3-4 MONTHS - 2 YRS HEALTHY WELL NOURISHED INTERMITTENT EPISODES OF

IRRRITABILITY AND PAIN, BENDING KNEES

VOMITING, CURRANT JELLY STOOLS

CONTRAST ENEMA

KEY ISSUES

DO NOT WAIT FOR BILIOUS VOMITING

DO NOT WAIT FOR BLOOD IN STOOL

YOUNGER….LETHARGY THINK ABOUT DIAGNOSIS

MALROTATION

NEWBORN… ANY AGE BILIOUS OR “YELLOWISH”

VOMITING MAY OR MAY NOT HAVE

ABDOMINAL DISTENTION

UGI

MALROTATION …VOLVULUS

STRANGULATION OBSTRUCTION AGAINST TIME

ABDOMINAL PAIN

FOREGUT

MIDGUT

HINDGUT

F

M

H

APPENDICITIS

MECKEL’S DIVERTICULUM

BLEEDING INFLAMMATION OBSTRUCTION

BANDS INTUSSUSCEPTION

MECKEL’S DIVERTICULUM

SMALL BOWEL OBSTRUCTION

HISTORY AND PHYSICAL ABDOMNAL X- RAYS TO CONFIRM

DIAGNOSIS

BILIOUS VOMITING:MECHANICAL OBSTRUCTION UNTIL PROVEN OTHERWISE

SBO: KEY ISSUES PRIOR SURGERY?......ADHESIVE OBSTRUCTION

INCARCERATED HERNIA?

INTUSSUSCEPTION?

APPENDICITIS?

CONGENITAL MALROTATION…VOLVULUS BANDS

ESOPHAGEAL ATRESIA

WITH TRACHEOESOPHAGEAL FISTULA

WITHOUT FISTULA

ESOPHAGEAL ATRESIA

POLYHYDRAMNNIOS MUCOSY BABY UNABLE TO INSERT NG TUBE ABDOMINAL EXAM/X RAY

VACTERL ASSOCIATION

VERTEBRAL ANORECTAL CARDIAC TRACHEOESOPHAGEAL RENAL LIMBS

DIAPHRAGMATIC HERNIA

POSTEROLATERAL DEFECT (BOCHDALEK)

ANTERIOR DEFECT (MORGAGNI)

DIAPHRAGMATIC HERNIA

PULMONARY HYPOPLASIA

PERSISTENT FETAL PULMONARY CIRCULATION

HIGH MORTALITY

INGUINO-SCROTAL PATHOLOGIES

HYDROCELE

HERNIAS

INGUINAL HERNIA (4)

INCARCERATION STRANGULATION

TESTIS BOWEL OVARY

INCARCERATION

NON REDUCIBLE MASS

INTESTINAL NECROSIS WRONG TECHNIQUE WRONG DIAGNOSIS

HYDROCELE TESTICULAR TORSION EPIDIDYMITIS/ORCHITIS LYMPH NODE ABSCESS

TESTICULAR TORSION

VARICOCELE

KISS PRINCIPLE

HYDROCELETESTICULAR TORSION. OTHER SCROTAL PATHOLOGY

GROIN EMPTY

REDUCIBLE HERNIA

INCARCERATED HERNIA

GROINFULL

NO PAINPAIN