Congenital Duodenal Obstruction
Epidemiology and Etiology Epidemiology Etiology Clinical Presentation Signs and symptoms of intestinal obstruction: Associated abnormalities: Diagnosis and Management Diagnosis History Physical exam Imaging Management Medical therapy Surgical management References
Pediatric Constipation
Overview Definition Constipation is a relative term and depends on a number of factors including frequency, consistency, and difficulty in passage of stool: A hard stool (consistency) passed every 3rd day (frequency) with “difficulty” requires management. A soft stool that is passed without difficulty every 2–3 days is not constipation. The Paris Consensus on Childhood […]
Esophageal Atresia and Tracheoesophageal Fistula
Overview Definitions Tracheoesophageal fistula (TEF) and esophageal atresia (EA) are congenital malformations of the esophagus and lower respiratory tract. Epidemiology Etiology Classification of EA and TEF Types Description Incidence Type A EA without TEF Approximately 8% of cases Type B EA with TEF to the proximal esophageal segment Approximately 1% of cases Type C EA […]
Congenital Renal Abnormalities
Renal Embryology The kidney develops in the pelvis and migrates cranially. Three separate renal systems form in sequence, giving rise to the kidney, in association with the urinary tract and urogenital system: Disorders of the Renal Parenchyma Introduction Renal embryologic disorders affecting the size, the shape, or the structure of kidney parenchyma (renal dysgenesis): Renal […]
Fluid Replacement Therapy in Children
Overview Definition Dehydration (hypovolemia) is a decrease in total body water, both intracellular and extracellular. Epidemiology Dehydration in children worldwide is primarily caused by diarrhea: Diarrhea accounts for 1 of 9 deaths in children worldwide. 300 children/year die from diarrhea in the United States. Most diarrhea is infectious: Viral (75%–90%): rotavirus, norovirus, and enteroviruses Bacterial […]
Acute Bronchiolitis
Overview Definition Acute bronchiolitis is a clinical constellation of respiratory symptoms (increased work of breathing, wheezing, and crackles) caused by acute inflammation of the small airways (small bronchi and bronchioles), typically secondary to viral infections. Epidemiology Etiology Pathophysiology and Clinical Presentation Pathophysiology Pathologic changes are noted within 24 hours of contact with a pathogen: Clinical […]
Blount’s Disease
Definition and Epidemiology Definition Blount’s disease (BD) is the progressive bowing of the legs produced by abnormal ossification at the medial aspect of the tibial epiphysis. Classification Early or infantile: debuts at 1–3 years of age Late; subdivided into: Juvenile form: presents at 4–10 years of age Adolescent form: occurs in children older than 10 […]
Pulmonary Stenosis
Overview Anatomy Pulmonary (or pulmonic) valve: Semilunar valve between the right ventricle (RV) and pulmonary artery (PA) Consists of 3 cusps: anterior, left, and right Opens during systole as the RV pressure exceeds the pulmonary trunk pressure Closes during diastole as the RV pressure drops (S2), preventing retrograde flow from the pulmonary trunk Table: Overview […]
Atrioventricular Septal Defect (AVSD)
Overview Definitions Classification Classification of AVSD is based on anatomy of defect: Epidemiology Etiology Pathophysiology Symptoms of AVSD (cyanosis, heart failure, and pulmonary hypertension) are due to excessive blood flow in the pulmonary system. Partial AVSD Complete AVSD Clinical Presentation Partial AVSD Complete AVSD Diagnosis Chest X-ray Severe partial or complete atherosclerotic cardiovascular disease (ASCVD): […]
Physical Examination of the Newborn
Introduction Before examining the infant, a thorough chart review should be performed. Maternal history Infant’s birth history Table: APGAR scoring Sign 0 points 1 point 2 points A Appearance Cyanotic or mottled Cyanotic extremities, pink body Pink extremities and body P Pulse Absent < 100/min > 100/min G Grimace No response to stimulation Grimace with […]