Important knowledge

⚡️Normaly direct bilirubin is <20% of total bilirubin (If more than 20% it mean direct hyperbilirubinemia)

clay-colored stool طين خاوة

⚡️polysplenia is pathognomonic for Syndromic biliary atresia

⚡️the most common surgically treatable cause of jaundice in the first two months of life is Biliary atresia

⚡️Meconium Ileus represents about one third (1/3) of neonatal intestinal obstruction

“string sign” Pyloric stenosis

⚡️Pyloric stenosis findings on US muscle thickness of ≥4 mm (≥ 3 mm in preterm) pyloric length of ≥16 mm ( ≥ 15 mm in preterm)

⚡️classical presentation of Pyloric stenosis Non bilious, projectile vomiting after each feeding in 2-8 weeks age infant and infant remain hungry after vomiting (with no fever )

⚡️treatment of achalasia in children🔥 - Calcium channel blooker - glyceryl trinitrate (GTN) - botox injection 💉 - surgery by esophagial myotomy ( Heller procedure)

⚡️Name of surgery for GERD is Fundoplication

Neonate Vs Adult anatomy

⚡️duodenal atresia assotiated anomalies (50% of cases) - the most common is Down syndrome (30% of duodenal atresia) - most serous one is cardiac anomalies

⚡️Intestinal atresia & stenosis are one of the most common causes of mechanical neonatal intestinal obstruction

Incision used in peadiatric surgery for open surgery (transverse supra-umblical incision) rather than vertical midline incision

#paediatric_surgery

مشاركة من صديق القناة

Bladder injury 🤕 مهم جدا - 90% associated with pelvic fracture 💯 Causes 1- blunt trauma (RTA) 2- Penetrating trauma 3- iatrogenic Types. مهمممممم 1- contusion: hematuria without leakage of urine. 2- extraperitoneal rupture: urine escape around the bladder not into peritoneal cavity. (Most common) 3- intraperitoneal rupture: urine leake into peritoneal cavity. 4- combined C/F : classical triad 👺 1- gross hematuria 2- suprapubic pain and tenderness 3- difficulty or inability in passing urine Diagnosis 🥸 1- retrograde cystography 350ml in adult....(age + 2) *30 in children 🔥 Flame shaped contrast in extraperitoneal مهم 2- CT cystography Management 1-bladder contusion Drainage by folley catheter (3 ways folley) Follow up cystography 2- extraperitoneal Folley catheter for 2 weeks then screen if healed then remove it, if not healed then another 2 weeks. To 6 weeks maximum. Antibiotics 3- intraperitoneal: emergency Exploratory laparotomy Cystotomy Suturing of the bladder wall defect Suprapubic tube Antibiotics

⚡️Renal tranplant is the most effective therapy for end stage renal disease.

Indicadion for dialysis in chronic renal failure

Alport syndrome triad - deafness - blindness (eye defect) - progressive renal damage