paediatric surgery overview-new
TRANSCRIPT
PAEDIATRIC SURGERYAn Overview
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• General Considerations:
• * Most problems encountered are in the form of congenital
anomalies, however, the pediatric age group are also liable for the common surgical diseases and trauma.
• *Delicate ,careful and professional interactions with their parents are
required.
• *Children are not like adults,they have unique fluids, electrolytes and medications needs all based on body weight.
• *Children with surgical conditions can deteriorate very rapidly, careful
attention to their physical findings and vital signs is required.
• *Always listen to the parents.
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Head and neck swellings:
• Please refer to the lecture given earlier, in children we add thymic
cyst to the differential diagnosis of midline swellings and definitely children will not have carotid body tumors.
• Again, remember that the commonist swelling in this age group is
also an enlarged L.N
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• Congenital diaphragmatic hernia:
• Bochdalic hernia
- Posterolateral
- hypoplastic lung
- diagnosed prenatally by USS
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GIT Anomalies:
• Approach to the vomiting infant:
It is important to differentiate between normal and abnormal vomiting.
1. What the vomit looks like?.
2. How sick is the baby. Generally:
• Vomit that looks like feeds and come immediately after feeding is almost always gastroesophageal reflux.
• * vomit that occurs a short while after feed and is projectile is due to pyloric stenosis.
• * Vomit that has any green colour is always worrisome.
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Oesophageal Atresia
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Pyloric Stenosis
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Duodenal Atresia
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Annular Pancreas
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Gastroschesis
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Biliary Atresia
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Intussusception
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• Meckles Diverticulum:
A true diverticulum
Rule of two's:
2% of population
2 feet ( 60 Cms)from the iliocecal valve
2 inches ( 5 Cms ) long
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• Complications of Meckles diverticulum:
1.Inflamation (diverticulitis)
2. Perforation
3. Obstruction
Reminant band
Leading point for intussusception.
4. Lower GI bleeding (heterogeneous gastric mucosa).
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Imperforated Anus
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Invertogram
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Undescended Testes
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Torsion Undescended Testes
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Torsion Testes
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Hernia
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Milroy's Disease
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Cystic Hygroma
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Wilms Tumour
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