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Neonatal Surgical Emergencies Dr. Shahaza Al Jawala Pediatric Consultant 12-1-2018
Neonatal Surgical Emergencies
Dr. Shahaza Al JawalaPediatric Consultant 12-1-2018
DISCLOSURE
Idonothaveanyrelevantfinancialrelationshipwithcommercialinteresttodisclose
OBJECTIVES
Recognizeandintervenewiththeuniquepresentationsofneonateswithsurgicalemergencies
HypertrophicPyloricStenosisqForcefulnonbiliousvomitingqO/E:dehydration,olive-likemassqLAB:lowKandCL,highHCO3qDx : 1- ultrasound
2- bariumstudiesqTx : Correctdehydrationandelectrolyte
Pyloromytomy
IntestinalAtresiaqDuodenalatresia:biliousornonbiliousvomitingq Jejunalandilealatresia:biliousvomiting,abdominaldistension
qDx :AXR1-Duodenalatresia:doublebubblewithdistalgasabsent2- Jejunalandilealatresia:dilatedbowel
qManagement:Surgicalanastomosis
Malrotation DiagnosisqBiliousornonbiliousvomiting,abdominaldistensionandtenderness,peritonitisandshock,hematochezia
qDx:AXR,upperGIcontrastseries,bariumenema,US
qUGI:AbnormalpositionofDuodenumifVolvulus“Bird’sbeak”induodenum
qMANAGEMENT:Stabilize,surgery
Hirschsprung’sDiseaseq1-Biliousvomitingwithabdominaldistensionandcannotpassstool2-Enterocolitis:Sepsis-likepictureFever,diarrhea,vomiting,abdominaldistension
q ToxicmegacolonqDIAGNOSIS:rectalbiopsyØ Surgicalresectionofganglionicsegmentalofbowel
CNSqSeizure,Abnormalmovement,Shock,Poorfeeding,Alteredlevelofconsciousness,grossanomaly
q Myelomeningocele,meningocele,SpinaBifidaq RapidlyProgressiveHydrocephalusq IntracranialHemorrhage:Trauma,Prematurity,Bleedingdisorder
UrologicAnomaliesqARF,UTI,VUR,PUV,HydronephrosisqPUJobstructionq MegaUreter,EctopicUreter,Ureteroceleq BladderExtrophyq DuplicationofrenalcollectionCystq Management:Nephrostomy,DoubleJ,SurgicalRepair,Tx RenalFailure
Thankyou
