Common surgical problems of the Neonate PDF

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Common surgical problems of the Neonate Two main indications: - Premature - Congenital Obstruction of Bowel = intra lumen, outside lumen or in the bowel wall. First baby poo = black Necrotising Enterocolitis (NEC): – perforation in gut of premature babies. Symptoms = poor feeding, bloating, decreased activity, blood in the stool, or vomiting of bile Pneumoperitoneum on Xray – in premature babies, gut isn’t supposed to be used yet, bowel perforates gas into peritoneum. Gas under diaphragm. Jejunal atresia: - ‘baggy bowels’ in distension not good for regaining good tone, so tends to be disposed of. - Anastomose tow good parts together and get rid of over dilated section Malrotation: - Bile = green (emergency for child) v bad. Indicates malrotation! FAIRY LIQUID - Black bowels – ischaemic dead, TOO LATE Meconium ileus: - Use contrast XR, bowel dilated before ileus + contrast from rectum will only go as far as ileus. - CF = high risk factor (not enough secretions to allow meconium to pass) Inguinal hernia: - Obstruction can show as ‘laddering’ on XR in abdomen....