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PAEDIATRIC GENERAL SURGERY (1) JUAN BASS MD FRCSC.

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Presentation on theme: "PAEDIATRIC GENERAL SURGERY (1) JUAN BASS MD FRCSC."— Presentation transcript:

1 PAEDIATRIC GENERAL SURGERY (1) JUAN BASS MD FRCSC

2 PEDIATRIC SURGICAL REVIEW PYLORIC STENOSIS INTUSSUSCEPTION MALROTATION SMALL BOWEL OBSTRUCTION APPENDICITIS- MECKEL’S

3 PEDIATRIC SURGICAL REVIEW ESOPHAGEAL ATRESIA CONGENITAL DIAPHRAGMATIC HERNIA

4 PEDIATRIC SURGICAL REVIEW INGUINOSCROTAL PATHOLOGIES: HYDROCELE HERNIA TESTICULAR TORSION VARICOCELE

5 PYLORIC STENOSIS

6 NON BILIOUS VOMITING PROGRESSIVE…..PROJECTILE

7 DIFFERENTIAL DIAGNOSIS PYLORIC STENOSIS FEEDING INTOLERANCE G.E. REFLUX INFECTIONS UTI CNS GI

8 HYDRATION FONTANELLE EYES MUCOUS MEMBRANES SKIN TURGOR URINARY OUTPUT

9 ABDOMINAL EXAMINATION GASTRIC DISTENTION GASTRIC PERISTALTIC WAVES PYLORIC OLIVE

10 PRIORITIES REHYDRATION CORRECTION OF ELECTROLYTE AND METABOLIC ABNORMALITIES CONFIRM DIAGNOSIS

11 METABOLIC ALKALOSIS HYPOCHLOREMIA HYPOKALEMIA RENAL LOSS

12 ULTRASOUND

13 PYLOROMYOTOMY REHYDRATED NORMAL ELECTROLYTES ALKALOSIS CORRECTED

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15 INTUSSUSCEPTION 3-4 MONTHS - 2 YRS HEALTHY WELL NOURISHED INTERMITTENT EPISODES OF IRRRITABILITY AND PAIN, BENDING KNEES VOMITING, CURRANT JELLY STOOLS

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17 CONTRAST ENEMA

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19 KEY ISSUES DO NOT WAIT FOR BILIOUS VOMITING DO NOT WAIT FOR BLOOD IN STOOL YOUNGER….LETHARGY THINK ABOUT DIAGNOSIS

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21 MALROTATION NEWBORN… ANY AGE BILIOUS OR “YELLOWISH” VOMITING MAY OR MAY NOT HAVE ABDOMINAL DISTENTION

22 UGI

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26 MALROTATION …VOLVULUS STRANGULATION OBSTRUCTION AGAINST TIME

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29 ABDOMINAL PAIN FOREGUT MIDGUT HINDGUT F M H

30 APPENDICITIS

31 MECKEL’S DIVERTICULUM BLEEDING INFLAMMATION OBSTRUCTION BANDS INTUSSUSCEPTION

32 MECKEL’S DIVERTICULUM

33 SMALL BOWEL OBSTRUCTION HISTORY AND PHYSICAL ABDOMNAL X- RAYS TO CONFIRM DIAGNOSIS

34 BILIOUS VOMITING: MECHANICAL OBSTRUCTION UNTIL PROVEN OTHERWISE

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36 SBO: KEY ISSUES PRIOR SURGERY?......ADHESIVE OBSTRUCTION INCARCERATED HERNIA? INTUSSUSCEPTION? APPENDICITIS? CONGENITAL MALROTATION…VOLVULUS BANDS

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38 ESOPHAGEAL ATRESIA WITH TRACHEOESOPHAGEAL FISTULA WITHOUT FISTULA

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

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41 VACTERL ASSOCIATION VERTEBRAL ANORECTAL CARDIAC TRACHEOESOPHAGEAL RENAL LIMBS

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43 DIAPHRAGMATIC HERNIA POSTEROLATERAL DEFECT (BOCHDALEK) ANTERIOR DEFECT (MORGAGNI)

44 DIAPHRAGMATIC HERNIA PULMONARY HYPOPLASIA PERSISTENT FETAL PULMONARY CIRCULATION HIGH MORTALITY

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47 INGUINO-SCROTAL PATHOLOGIES

48 HYDROCELE

49 HERNIAS

50 INGUINAL HERNIA (4) INCARCERATION  STRANGULATION TESTIS BOWEL OVARY

51 INCARCERATION

52 NON REDUCIBLE MASS INTESTINAL NECROSIS WRONG TECHNIQUE WRONG DIAGNOSIS HYDROCELE TESTICULAR TORSION EPIDIDYMITIS/ORCHITIS LYMPH NODE ABSCESS

53 TESTICULAR TORSION

54 VARICOCELE

55 KISS PRINCIPLE HYDROCELETESTICULAR TORSION. OTHER SCROTAL PATHOLOGY GROIN EMPTY REDUCIBLE HERNIA INCARCERATED HERNIA GROIN FULL NO PAINPAIN

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