Pediatric Surgery Review - JFrischer

Pediatric Surgery Review - JFrischer - Pediatric Surgery...

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Unformatted text preview: Pediatric Surgery Review Jason Frischer March 18, 2004 1. An 8 hr old infant drools and returns his first feed. A tube in passed into the esophagus and a film obtained. What is the diagnosis? Esophageal Atresia and Tracheoesophageal Fistula Incomplete partitioning of primitive foregut 5 types of atresias Esophageal atresia with distal TEF most common 8% 1% 85% 2% 4% Esophageal Atresia and Tracheoesophageal Fistula Can be part of VACTERL anomalies vertebral, anal, cardiac, TEF, renal, limb Atresias detected by inability to pass NGT/OGT TEF w/o atresia presents with recurrent aspiration Low-risk infants should get primary repair long gap (>3 vertebral bodies) repair is delayed high-risk babies get gastrostomy Post-op complications include esophageal leak, dysmotility, GE reflux, strictures 2. A 5-wk-old boy presents with 3 days of non- bilious projectile vomiting and dehydration. Which of the following is TRUE about his condition? A. Immediate laparotomy is warranted. B. UGI series is the diagnostic procedure of choice. C. Delay in diagnosis leads to metabolic acidosis. D. Most commonly seen in females. E. Fluid replacement consists of NS + KCL 2. A 5-wk-old boy presents with 3 days of non- bilious projectile vomiting and dehydration. Which of the following is TRUE about his condition? A. Immediate laparotomy is warranted. B. UGI series is the diagnostic procedure of choice. C. Delay in diagnosis leads to metabolic acidosis. D. Most commonly seen in females. E. Fluid replacement consists of NS + KCL Pyloric Stenosis 1 in 600 births, male: female ratio 4:1, 3-12 weeks Gastric outlet obstruction due to hypertrophy of pyloric muscle Progressive, projectile non-bilious vomiting Hypochloremic, hypokalemic metabolic alkalosis renal compensation for hypovolvemia Sono is diagnostic procedure of choice thickness > 5 mm, channel length > 15 mm Repair via Fredet-Ramstedt pyloromyotomy Pyloromyotomy 3. A 6-wk-old infant presents with jaundice. A sonogram appears normal. HIDA scan fails to demonstrate emptying into the duodenum. What is the next best step in management? A. List for liver transplant. B. Follow closely until 3 months of age, then do Kasai. C. Percutaneous liver biopsy. D. Initiate anti-inflammatory therapy. E. Laparotomy with operative cholangiogram and liver biopsy, then Kasai if warranted. 3. A 6-wk-old infant presents with jaundice. An abdominal USG appears normal. HIDA scan fails to demonstrate emptying into the duodenum. What is the next best step in management? A. List for liver transplant. B. Follow closely until 3 months of age, then do Kasai....
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Pediatric Surgery Review - JFrischer - Pediatric Surgery...

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