Professional Documents
Culture Documents
Malrotation
Batool Shwayat
Malrotation : there is arresting of the rotation of the cecum at 180 degrees . so the cecum will be in the
Right hypochondrium in front of the duodenum .
- could be asymptomatic .
Family history play a role .
may be associated with other congenital anomalies.
Symptoms :
1- Duodenal obstruction ( tight band ) : bilious vomiting , abdominal distension and delayed passage of
meconium .
2- Intermittent obstruction ( not very tight ) : partial twisting of the mesentry .
3- volvulus : complete twisting (the most dangerous ).
Volvulus Neonatorum
Causes: the mid gut rotate around its mesenteric attachmet = less dramatic symptoms.
or when the mid gut rotate many times .
Results: Mechanical obstruction: when the band compresses the 2nd part
Ischemic obstruction : no blood supply = strangulation
Tt : in early stage : derotation ( blood supply is normal )
Late stage : resection (gangrenous ).
1234-
surgical causes
- neonatal intestinal obstruction .
- sphincteric disorders :1-pyloric stenosis (most imp)
2-GERD :with or without HH
3-Achalasia in older age group.
Umbilical
Very common( neonates and infant)
Spontaneous closure
Tt: - conservative: if the diameter is less than
1cm.
-Surgery :if the defect is wide after the 2nd
year or if it is enlarging
Cause : failure of the umbilical cicatrix to
contract or to close
paraumbilical
Less ( adults)
Not closed spontaneously
Surgery is indicated
Discharging Umbilicus
blood :
- Umbilical granuloma : blood +pus +red lesion
-at the site of the cut of the umbilical cord
-tt: cautery +antibiotics
-umblical polyps :
- persistence of omphalomesentric duct
- tt : excision
Complications : - sepsis
the inflammatory process pass deeply along the Portal vein= portal vain
thrombosis =portal HTN= esophageal varices= hematemesis.
Urine : -patent urachus : fistula between the bladder and the umbilicus
Tt : excision
Feces : persistence omphalomesentric duct .
Gastroscisis
No membrane
10%
2-5 cm
Complications :
contamination + heat loss + fluid loss