Neonatal Surgical Emergencies - Q-PEMq-pem.com/.../07/Day-2-Track-4-neonatal-shahaza.pdf ·...

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