<\/p>\n
There are five anatomical sites of narrowing in the pediatric esophagus, which are: the cricopharyngeus muscle level at C6; the thoracic inlet at T1; the cardioesophageal level or aortic arch at T4; the tracheal bifurcation at T6; and the gastroesophageal junction or hiatal narrowing.<\/p>\n
Infectious Colitis<\/strong><\/p>\n Shigella<\/p>\n Salmonella<\/p>\n Enteroinvasive E. Coli<\/p>\n Campylobacter Jejuni<\/p>\n Yersinia<\/p>\n C. Difficile<\/p>\n Entamoeba histolytica<\/p>\n E. Coli 0157:H7<\/p>\n Painless Rectal Bleeding<\/strong><\/p>\n Anal Fissure<\/p>\n Swallowed Maternal blood (distinguish with apt test)<\/p>\n Meckel’s diverticulum<\/p>\n Infectious gastroenteritis<\/p>\n Juvenile polyps<\/p>\n <\/p>\n Upper gastrointestinal bleeding<\/strong> Bleeding disorders Esophagitis Swallowed maternal blood Ulcers Vascular malformationsLower gastrointestinal bleeding<\/strong> Anal fissure Bleeding disorders Infectious colitis Milk allergy Meckel\u0092s diverticulum Necrotizing enterocolitis Swallowed maternal blood Volvulus<\/p>\n <\/p>\n <\/p>\n Rules of 2.\u00a0 2% of population.\u00a0 2 feet proximal to terminal ileum.\u00a0 2% of people with meckel\u0092s will have problems.\u00a0 Usually has ectopic gastric mucosal.<\/p>\n true diverticulum causing painless rectal bleeding<\/p>\n Can be the focus of a volvulus or intussusception<\/p>\n Get fingerstick, UA, Icon (if appropriate age and sex). drop the diaper to examine testicles, and look in the throat to avoid missing diagnoses.\u00a0 If patient is a virgin female, can assess adnexa by bimanual rectal exam.<\/p>\n <\/p>\n Surgical emergency if volvulus, surgical urgency if obstruction<\/p>\n Any infant with bilious vomiting, especially \u00a0in 1st week of life<\/p>\n double bubble sign on upright x-ray.\u00a0 Absence of ligament of treitz.\u00a0 Bloody stool.<\/p>\n blood streaking in stool<\/p>\n generally <1 yr of age<\/p>\n bilious vomitting, abdominal tenderness, palpable mass, UGI series or ultrasound can confirm dx<\/p>\n projectile bilious vomiting from 2-6 months<\/p>\n firstborn males.<\/p>\n Examine with the infant on their back, flex their hips 90\u00b0 to relax abd.\u00a0 May palpate the olive by gently starting palpation with rocking motion below the liver, usually found on the right, just below the Xiphoid.\u00a0 Ultrasound is the test of choice.\u00a0 Will get hypochloremic, hypokalemic metabolic alkalosis.\u00a0 Must correct pH and electrolytes before the OR.<\/p>\n Classic triad:\u00a0 colicky intermittent abd pain, vomiting,\u00a0 guiac + stools<\/p>\n A chart entry of, “No crampy abdominal pain pattern observed during ED stay”, would provide clinical evidence against the diagnosis of intussusception The differential of an infant presenting with lethargy should include sepsis, hypoglycemia, intussusception, Guillain-Barre syndrome, infant botulism, post-seizure lethargy and child abuse (shaken infant).<\/p>\n usually will have lead point such as peyer\u0092s patches, polyps, or meckel\u0092s<\/p>\n May have RUQ mass as ileocecal junction is the most common location<\/p>\n Neuro symptoms are associated with this disease and can include weakness, lethargy, and seizures.<\/p>\n Air enema or obstructive series as first test. \u00a0Can also be seen on UTS.<\/p>\n can present with diarrhea.\u00a0 Get CBC and UA<\/p>\n Compression graded UTS can be used, but CT is the better test.<\/p>\n In children less than 2 yrs old, symptoms may include cough, grunting, or walking with a limp. (Annals EM 36:39-51, 2000).\u00a0 Diarrhea is present in up to 1\/3 of children under 3 y\/o with appendicitis (Am J Surg 173:80-82, 1997)<\/p>\n Ask the child how high they can jump, then let them show you to test rebound.<\/p>\n Can have white cells in urine, sometimes even bacteria (J Urol 129:1015, 1988 and Am J Surg 155(2), 1988)<\/p>\n strangulated needs immediate op, incarcerated needs intervention.\u00a0 Umbilical hernias are common, especially in African Americans.\u00a0 Rarely become incarcerated.<\/p>\n The identification of a pediatric bowel obstruction is best described using four parameters: 1) gas distribution, 2) bowel distention, 3) air fluid levels, and 4) orderliness. These four parameters are not as easy as they sound. Bowel distention does not refer to the diameter of the bowel, but rather, the SMOOTHNESS of the bowel walls due to loss of haustration and plications. This looks like sausages or hoses because the walls are smooth. There are two common bowel obstruction patterns seen. Paucity of gas associated with a bowel obstruction is more commonly due to intussusception as opposed to the bowel obstruction pattern with large dilated loops and air fluid levels (7).<\/p>\n <\/p>\n Neurologic Symptoms, including hallucinations can precede the diarrhea in shigellosis (J Ped 114(1):95, Jan 1989)<\/p>\n The results of this meta-analysis confirm those of most individual clinical trials and two smaller meta-analyses indicating that the administration of probiotics as an adjunct to rehydration reduces the duration of acute diarrhea in children by about one day. (Dig Dis Sci 47(11):2625, November 2002)<\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n |\u00a0\u00a0 \u00a0\u00a0 |\u00a0\u00a0 \u00a0\u00a0 |<\/p>\n","protected":false},"excerpt":{"rendered":" Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[11],"tags":[],"yoast_head":"\nCommon Causes Of Upper And Lower Gastrointestinal Bleeding In The Newborn. (EMP)<\/h4>\n
Meckel\u0092s Diverticulum<\/h4>\n
<\/span>Surgical Emergencies<\/span><\/h2>\n
Malrotation (One to Two Weeks)<\/h4>\n
Pyloric Stenosis (One to Two Months)<\/h4>\n
Intussusception (One to Two Years)<\/h4>\n
Appendicitis (Any Age)<\/h4>\n
Incarcerated Hernias<\/h4>\n
Bowel Obstruction<\/h4>\n
<\/h4>\n
<\/span>Diarrheal Illness<\/span><\/h2>\n