GI

Question 1

When is embryological development of the bowel usually completed by?

Answer 1

8 weeks gestation

Question 2

What is the normal rotation of the gut embryologically?

Answer 2

Foregut, midgut and hindgut herniate out of the abdominal cavity, they rotate 270degrees around the superior mesenteric vessels and then return to the abdominal cavity

Question 3

What are the symptoms of a volvulus?

Answer 3

Bilious vomiting
Abdominal distension
Peritonitis
Shock
Haematochezia - fresh blood PR

Question 4

How is malrotation +/- volvulus diagnosed?

Answer 4

AXR
Contrast study

Question 5

What sign would appear on a contast study if a small bowel volvulus is present?

Answer 5

Corkscrew sign

Question 6

What is the management for a child with malrotation with volvulus?

Answer 6

NGT on free drainage
IV fluids
Keep NBM
Surgical correction