Pediatric Abdominal emergencies PDF
Preview Pediatric Abdominal emergencies
Pediatric abdominal n o m m o emergencies C In the first year of life Kristian Stien Thomassen Section of Pediatric Radiology Dept. of Radiology and Nuclear Medicine Oslo University Hospital Understand the age distribution of common pediatric abdominal emergencies • Describe the most common clinical presentation of these emergencies • Choose the most appropriate imaging • Interpret the most common imaging findings • Finish in time for lunch :) References «Barnekirurgi» / «Pediatric surgery» - dr. Sigvald Refsum • «Caffey´s - Pediatric Diagnostic imaging» - Briand D. Coley • ! «Essential diagnosis of abdominal emergencies in the first year of life» - Louie • et al. Emerg Med Clin North Am. 2007 Nov;25(4):1009-40 «Emergent Pediatric US: What Every Radiologist Should Know» - Cogley et al. • Radiographics. 2012 May-Jun;32(3):651-65. doi: 10.1148/rg.323115111. ! ! If not otherwise stated, all radiological images from Dept. of Radiology and • Nuclear medicine, Oslo University Hospital Pediatric abdominal emergencies Age - definitions Pre-term neonate Full-term neonate Infant GA 23/24w - 36w 6d 31d - 12 months GA 37w - 42w ≤ 31 days of age Pediatric abdominal n o m m o C emergencies Neonates Infants Malrotation with volvolus! Hypertrophic pyloric stenosis! • • Necrotizing enterocolitis! Incarcerated inguinal hernia • • Omphalitis! Intussusception! • • Hirschprung´s Disease Appendicitis • • Malrotation Malrotation —) Failure of the • midgut to undergo appropriate rotation and retroperitoneal fixation during early fetal life. ! Normally there is a 270º • counterclockwise rotation ! «Midgut» = Duodenum (distal to • ampulla vateri) to distal 2/3 of transverse colon ! Supplied by superior mesenteric • artery Malrotation with volvolus Varying degrees of malrotation giving a Approximation wide spectrum of symptoms: of duodenum and coecum Asymptomatic, incidental finding • Chronic (partial/intermittent) volvolus • Suspension Acute volvolus • from a narrow ! mesenteric ! pedicle Malrotation with volvolus Venous congestion, ischemia, necrosis Malrotation with volvolus Epidemiology Clinical presentation Bilious vomiting • 1 in 5000 live births • Hematochezia • 80% of cases presents within 1st • Abdominal distension • month of life Pain • Males 2:1 Females • Shock • ! Differential diagnosis Gradual, but rapid progression of Meconium ileus symptoms • Hirschprung´s disease • Duodenal atresia • NEC • Malrotation with volvolus - Imaging Plain abdominal radiograph Upper GI series Ultrasound
Description:The list of books you might like
