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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