PEDI | GI

https://statstitch.etsy.com1. Pediatric GI Physiology & Fluid Balance• Assessment: Evaluate hydration status via fontanels (sunken = dehydration), skin turgor, mucous membranes, and urine output.• Management:◦ Mild/Moderate Dehydration: First-line treatment is Oral Rehydration Solution (ORS) (e.g., Pedialyte) in small, frequent amounts.◦ Severe Dehydration: Requires isotonic IV fluids (e.g., normal saline).2. Structural AnomaliesThese congenital defects require immediate protection of the airway or defect and surgical intervention.• Cleft Lip/Palate: Major concerns are feeding difficulties and aspiration. Use specialty bottles (e.g., Haberman) and keep the infant upright. Post-op: Protect the suture line (no pacifiers, use elbow restraints).• Esophageal Atresia (EA) & Tracheoesophageal Fistula (TEF): Watch for the "Three C’s": Coughing, Choking, and Cyanosis during feeding. Management includes immediate NPO status, elevating the head, and surgical repair.• Abdominal Wall Defects:◦ Omphalocele: Organs in a sac.◦ Gastroschisis: Herniated bowel without a sac.◦ Care: Prevent hypothermia and cover the defect with a sterile, non-adherent, moist dressing immediately after birth.• Anorectal Malformations: Assess for failure to pass meconium in the first 24 hours (imperforate anus).3. Acute & Obstructive DisordersThese conditions often present as emergencies requiring rapid recognition of specific symptoms.• Hypertrophic Pyloric Stenosis: Characterized by projectile, non-bilious vomiting and a palpable "olive-shaped" mass in the RUQ. Treated via pyloromyotomy.• Intussusception: The telescoping of the bowel causing edema and obstruction. Classic signs are "currant jelly" stools (blood/mucus) and a sausage-shaped abdominal mass. Treatment is often a pneumatic (air) enema.• Appendicitis: Inflammation causing RLQ pain (McBurney’s point). Warning: A sudden relief of pain may indicate rupture and peritonitis.4. Chronic & Inflammatory DisordersManagement focuses on diet, medication, and preventing growth failure.• Hirschsprung Disease (Megacolon): Absence of ganglion cells in the colon leads to obstruction. Signs include failure to pass meconium and ribbon-like stools. Surgical removal of the aganglionic section is required.• Gastroesophageal Reflux (GERD): Common in infants. Management includes thickening feeds with rice cereal, keeping the infant upright for 30 minutes post-feed, and medications (PPIs). Severe cases may need a Nissen fundoplication.• Celiac Disease: Immunological reaction to gluten damaging small intestine villi. Symptoms include steatorrhea (fatty stools) and failure to thrive. Strict lifelong avoidance of wheat, barley, rye, and oats is the only cure.• Biliary Atresia: Bile duct obstruction leading to liver failure. Presents with jaundice and pale stools. The Kasai procedure is the primary treatment, though liver transplant is often eventually needed