Pediatric GI tract Flashcards Preview

Radiology > Pediatric GI tract > Flashcards

Flashcards in Pediatric GI tract Deck (14)
Loading flashcards...
1
Q

what do for de keeds

A

FIRST
a plain film abominal XR
to check for free air, obstruction, torsion

Then if needed a contrast x ray

2
Q

pediatric GI probs

A

Esophageal atresia - completely closed off lumen of the esophagus - very often with a single or double fistula to the trachea - Trachoesophageal fistula

3
Q

X ray findings of esophageal atresia with a lower tracheoesophageal fistula

A

If the lungs are connected to the esophagus somewhere below the atresia, the lungs will slowly fill the GI tract with gas. Air will be seen filling the intestinal loops.

When a contrast agent is attempted to be administered, the catheter will hit the atretic dead end of the esophagus.

4
Q

Hypertrophic pyloric stenosis

A

Presents bombastically at 3-6 week infants. with FREQUENT PROJECTILE VOMITING, that is non-bilious

The pylorus is visible on Ultrasound clearly.
Enlarged, 15mm or more and thick walled, 3mm or greater thickness

5
Q

Duodenal obstruction

A

From atresia or stenosis

Diagnosed by US:
distended stomach and duodenum proximally, showing the ‘Double Bubble’ sign.
with empty small intestines distally.
If it is atresia the distal intestines will have no gas in them,
stenosis they will have some air.

6
Q

Volvulus

A

Symptoms: Bilious vomiting

The whirlpool sign on Doppler US.
The Mesenteric Vein and Artery are the vessels creating this sign.

Also there will be excessive small bowel loops on the right side of the stomach.

7
Q

Meconium Ileus

A

In 10% of children with cystic fibrosis, and if it occurs CF should be highly suspected. Rarely occurs outside of it.

Symptoms:
Vomiting, Abdominal distension
Intestines are distended but LACK air fluid levels, due to the thick adhesive nature of the meconium.

Contrast enema examination will show a very narrow, non-used colon, and the contrast will be stopped at the terminal illeum,

8
Q

Intususception

A

Target sign, can cause intestinal necrosis

Symptoms: Reccurent, colicy crying
Distended intestines
Palpable abdominal mass
Vomiting
Bloddy stool. 

Treatment: Hydrostatic or pneumatic desinvagination are possible treatments, guided by ultrasound or fluoroscopy.
Any indications of Perforation or Peritonitis,are absolute contraindications.
In this case surgery must be performed immediately

9
Q

Necrotizing enterocolitis

A

Vomiting, distended abdomen, bloody stool, acidosis, peritonitis, perforation

In early stages no signs are apparent on AXR.
Eventually:
Intestinal pneumatosis may be seen, with air bubbles in the intestinal submucosal or subserosal layers - from necrosis.
Free abdominal air.

10
Q

Hirschsprung disease, congenital megacolon

A

No ENS function.

Symptoms are apparent right away, the baby never defecates the meconium.
X ray shows distended intestines with or without air fluid levels.

11
Q

What is used to examine newborn Urogenital system

A

Ultrasound

MCU is gold standard

12
Q

Miction cystourethrography

A

Aka Voiding cystourethrography
Contrast is administered into the urinary bladder via a catheter, and then voiding is examined by X ray fluoroscopy, to check for reflux into the ureters.

13
Q

Sonocystography

A
Ultrasound contrast (lipid coated microbubbles)
is administered to the bladder via catheter, and then the bladder and ureters are examined by US during urination to check for reflux.
14
Q

Congenital obstructive uropathies examles

A

Uretreopelvic obstruction - Obstruction of the ureters high up right at the pelvis.

Distal urethral valve obstruction, at the level of the uretrovesicular junction. This one is more sever, causing more severe hyronephrosis and hyrouretereal dilation, pyelonephritis.

Decks in Radiology Class (43):