Pediatric Surgery

Pediatric Surgery US Medical PG Question 1: A new mother expresses her concerns because her 1-day-old newborn has been having feeding difficulties. The child vomits after every feeding and has had a continuous cough since shortly after birth. The mother denies any greenish coloration of the vomit and says that it is only composed of whitish milk that the baby just had. The child exhibits these coughing spells during the exam, at which time the physician notices the child’s skin becoming cyanotic. The mother states that the child was born vaginally with no complications, although her records show that she had polyhydramnios during her last ultrasound before the delivery. Which of the following is the most likely cause of the patient’s symptoms?

• A. Failure of recanalization of duodenum
• B. Obstruction due to failure of rotation of pancreatic tissue
• C. Hypertrophy of the pyloric sphincter
• D. Failure of neural crest cells to migrate into the myenteric plexus
• E. Defective formation of the esophagus with tracheoesophageal connection (Correct Answer)

Pediatric Surgery Explanation: ***Defective formation of the esophagus with tracheoesophageal connection*** - The combination of **feeding difficulties**, vomiting of **undigested milk**, **continuous coughing**, and **cyanosis** during coughing spells in a newborn strongly suggests a **tracheoesophageal fistula (TEF)**, often with **esophageal atresia**. - **Polyhydramnios** during pregnancy is a classic prenatal sign due to the fetal inability to swallow amniotic fluid. *Failure of recanalization of duodenum* - This condition, known as **duodenal atresia**, typically presents with **bilious vomiting** if the obstruction is distal to the ampulla of Vater, or non-bilious if proximal, but typically does not cause continuous coughing or cyanosis during feeds. - While it causes vomiting, it primarily affects digestion and nutrient absorption, and **polyhydramnios** can also be present due to impaired fetal swallowing. *Obstruction due to failure of rotation of pancreatic tissue* - This describes **annular pancreas**, where pancreatic tissue encircles the duodenum, causing obstruction and **vomiting** (often bilious). - Like duodenal atresia, it doesn't explain the characteristic **coughing and cyanosis** with feeds seen in this case. *Hypertrophy of the pyloric sphincter* - **Pyloric stenosis** typically presents later (2-8 weeks of age) with **projectile non-bilious vomiting**, and an **olive-shaped mass** may be palpable in the abdomen. - It does not cause coughing or cyanosis that correlates directly with feeding in a 1-day-old. *Failure of neural crest cells to migrate into the myenteric plexus* - This describes **Hirschsprung disease**, which primarily affects the colon and presents with symptoms of **intestinal obstruction** (e.g., abdominal distension, failure to pass meconium, bilious vomiting if severe). - It is not associated with feeding difficulties, coughing, or cyanosis in the manner described.

Pediatric Surgery US Medical PG Question 2: A 7-day-old male infant presents to the pediatrician for weight loss. There is no history of excessive crying, irritability, lethargy, or feeding difficulty. The parents deny any history of fast breathing, bluish discoloration of lips/nails, fever, vomiting, diarrhea, or seizures. He was born at full term by vaginal delivery without any perinatal complications and his birth weight was 3.6 kg (8 lb). Since birth he has been exclusively breastfed and passes urine six to eight times a day. His physical examination, including vital signs, is completely normal. His weight is 3.3 kg (7.3 lb); length and head circumference are normal for his age and sex. Which of the following is the next best step in the management of the infant?

• A. Reassurance of parents (Correct Answer)
• B. Evaluation of the mother for malnutrition
• C. Admission of the infant in the NICU to treat with empiric intravenous antibiotics
• D. Emphasize the need to clothe the infant warmly to prevent hypothermia
• E. Supplementation of breastfeeding with an appropriate infant formula

Pediatric Surgery Explanation: ***Reassurance of parents*** - A **weight loss of 8.3%** (300g from 3.6kg) is within the expected range for a 7-day-old exclusively breastfed infant, which can be up to 7-10% in the first week. - The infant's normal physical exam, good urine output, and lack of other symptoms suggest **adequate feeding** and overall well-being. *Evaluation of the mother for malnutrition* - The mother's nutritional status is not directly indicative of the infant's weight loss within the normal physiological range in this scenario. - There is no information to suggest the mother is malnourished or that it would directly impact the quality or quantity of breast milk to cause pathological weight loss. *Admission of the infant in the NICU to treat with empiric intravenous antibiotics* - This is an overly aggressive intervention as there are **no signs or symptoms of infection** (e.g., fever, lethargy, poor feeding) and the infant appears well. - Empiric antibiotics are not warranted in an otherwise healthy, full-term infant with normal physiological weight loss. *Emphasize the need to clothe the infant warmly to prevent hypothermia* - The infant's **vital signs are normal**, indicating no hypothermia, and there is no clinical evidence to support this as a primary concern. - While maintaining warmth is important, it is not the next best step for addressing this specific presentation of physiological weight loss. *Supplementation of breastfeeding with an appropriate infant formula* - Supplementation is typically not needed for physiological weight loss in an otherwise healthy, exclusively breastfed infant with **adequate urine output** and no signs of dehydration. - Encouraging continued exclusive breastfeeding and providing support for proper latch and feeding techniques would be more appropriate if there were concerns about inadequate milk intake.

Pediatric Surgery US Medical PG Question 3: A 7-month-old boy is brought to the ED by his mother because of abdominal pain. Two weeks ago, she noticed he had a fever and looser stools, but both resolved after a few days. One week ago, he began to experience periodic episodes during which he would curl up into a ball, scream, and cry. The episodes lasted a few minutes, and were occasionally followed by vomiting. Between events, he was completely normal. She says the episodes have become more frequent over time, and this morning, she noticed blood in his diaper. In the ED, his vitals are within normal ranges, and his physical exam is normal. After confirming the diagnosis with an abdominal ultrasound, what is the next step in management?

• A. Supportive care
• B. Broad-spectrum antibiotics
• C. Air contrast enema (Correct Answer)
• D. Abdominal laparotomy
• E. Abdominal CT scan

Pediatric Surgery Explanation: ***Air contrast enema*** - An **air contrast enema** is both diagnostic and therapeutic for **intussusception**, which is strongly suggested by the patient's symptoms (colicky abdominal pain, drawing legs to chest, currant jelly stools). - It uses air pressure to **reduce the intussusception**, avoiding surgery if successful and the bowel is not compromised. *Supportive care* - While supportive care (IV fluids, pain control) is important, it does not address the underlying mechanical issue of **intussusception** and would not resolve the condition. - Delaying definitive treatment for intussusception can lead to **bowel ischemia, necrosis, and perforation**, which are life-threatening. *Broad-spectrum antibiotics* - Antibiotics are not the primary treatment for **intussusception**, as it is a mechanical obstruction, not typically a primary infection. - They might be considered if there are signs of **perforation or peritonitis**, but the immediate goal is reduction. *Abdominal laparotomy* - An **abdominal laparotomy** is a surgical intervention reserved for cases where **non-operative reduction** (like an air enema) fails or if there are signs of **bowel perforation or gangrene**. - It is not the *first-line* next step after diagnosis, especially if non-invasive options remain viable. *Abdominal CT scan* - An **abdominal CT scan** can diagnose intussusception but is typically not the preferred initial imaging because it involves **radiation exposure** and **does not offer therapeutic benefit**, unlike an air contrast enema. - Abdominal ultrasound is usually sufficient for diagnosis and safer for pediatric patients.

Pediatric Surgery US Medical PG Question 4: A 15-month-old boy is brought to the pediatrician for immunizations and assessment. His parents report that he is eating well and produces several wet diapers every day. He is occasionally fussy, but overall a happy and curious child. The boy was born at 39 weeks gestation via spontaneous vaginal delivery. On physical examination his vital signs are stable. His weight and height are above the 85th percentile for his age and sex. On chest auscultation, the pediatrician detects a loud harsh holosystolic murmur over the left lower sternal border. The first and second heart sounds are normal. An echocardiogram confirms the diagnosis of the muscular ventricular septal defect without pulmonary hypertension. Which of the following is the best management strategy for this patient?

• A. Surgical closure of the defect using cardiopulmonary bypass
• B. Reassurance of the parents and regular follow-up (Correct Answer)
• C. Oral digoxin and regular follow-up
• D. Antibiotic prophylaxis against infective endocarditis
• E. Transcatheter occlusion closure of the defect

Pediatric Surgery Explanation: **Reassurance of the parents and regular follow-up** - Most **small muscular VSDs (Ventricular Septal Defects)**, especially in asymptomatic children with normal growth and no signs of heart failure or pulmonary hypertension, **close spontaneously**. - Given the patient's normal development, stable vital signs, good feeding, and lack of pulmonary hypertension, a conservative approach with **monitoring for spontaneous closure** is appropriate. *Surgical closure of the defect using cardiopulmonary bypass* - **Surgical VSD closure** is typically reserved for large defects causing **symptoms, growth failure, pulmonary hypertension**, or those that fail to close spontaneously. - The patient in the scenario is asymptomatic and thriving, which does not warrant an invasive procedure at this time. *Oral digoxin and regular follow-up* - **Digoxin** is a medication used to improve **cardiac contractility** and manage symptoms of **heart failure**, which this patient does not exhibit. - It would only be considered if there were signs of **congestive heart failure** due to a large VSD, which is not the case here. *Antibiotic prophylaxis against infective endocarditis* - Current guidelines from the American Heart Association (AHA) generally **do not recommend routine antibiotic prophylaxis** for VSDs unless there's a history of infective endocarditis or uncorrected cyanotic heart disease. - The risk of **infective endocarditis** is very low in isolated VSDs and the potential side effects of prophylactic antibiotics outweigh the benefits. *Transcatheter occlusion closure of the defect* - **Transcatheter closure** is an option for certain types of VSDs, often **muscular VSDs**, but typically for those that are **larger, symptomatic**, and have not closed spontaneously. - Similar to surgical closure, this invasive procedure is not indicated for an **asymptomatic, thriving child** with a muscular VSD that is likely to close on its own.

Pediatric Surgery US Medical PG Question 5: A 4-month-old boy is brought to the physician for a well-child examination. He was born at 39 weeks gestation via spontaneous vaginal delivery and is exclusively breastfed. He weighed 3,400 g (7 lb 8 oz) at birth. At the physician's office, he appears well. His pulse is 146/min, the respirations are 39/min, and the blood pressure is 78/44 mm Hg. He weighs 7.5 kg (16 lb 9 oz) and measures 65 cm (25.6 in) in length. The remainder of the physical examination is normal. Which of the following developmental milestones has this patient most likely met?

• A. Sits with support of pelvis
• B. Grasps small objects between thumb and finger
• C. Transfers objects from hand to hand
• D. Intentionally rolls over (Correct Answer)
• E. Bounces actively when held in standing position

Pediatric Surgery Explanation: ***Intentionally rolls over*** - Rolling over is a common developmental milestone achieved between **4 to 6 months** of age. - At 4 months, an infant typically has sufficient **head control** and **trunk strength** to intentionally roll from tummy to back or back to tummy. *Sits with support of pelvis* - Sitting with **pelvic support** (tripod sitting) is generally achieved around **6 to 7 months** of age. - A 4-month-old typically lacks the necessary **trunk stability** and strength for this milestone. *Grasps small objects between thumb and finger* - This describes a **pincer grasp**, which is a fine motor skill usually developed around **9-12 months** of age. - At 4 months, infants primarily use a **palmar grasp** (raking motion) to pick up objects. *Transfers objects from hand to hand* - Transferring objects from hand to hand is a fine motor milestone typically achieved between **5 and 7 months** of age. - A 4-month-old is beginning to reach for objects but usually has difficulty with **smooth transfers** between hands. *Bounces actively when held in standing position* - Active bouncing when held in a standing position is typically seen around **6 months** when infants start putting more weight on their legs. - At 4 months, while an infant might bear some weight, **active bouncing** is usually more rudimentary or absent.

Pediatric Surgery US Medical PG Question 6: An 8-year-old boy is shifted to a post-surgical floor following neck surgery. The surgeon has restricted his oral intake for the next 24 hours. He does not have diarrhea, vomiting, or dehydration. His calculated fluid requirement is 1500 mL/day. However, he receives 2000 mL of intravenous isotonic fluids over 24 hours. Which of the following physiological parameters in the boy’s circulatory system is most likely to be increased?

• A. Interstitial oncotic pressure
• B. Interstitial hydrostatic pressure
• C. Capillary wall permeability
• D. Capillary oncotic pressure
• E. Capillary hydrostatic pressure (Correct Answer)

Pediatric Surgery Explanation: ***Capillary hydrostatic pressure*** - Giving 2000 mL of intravenous isotonic fluids when the calculated requirement is 1500 mL/day leads to a **positive fluid balance** and **fluid overload**. - This excess fluid directly increases the **intravascular volume**, thereby raising the **capillary hydrostatic pressure**, which pushes fluid out of the capillaries. *Interstitial oncotic pressure* - This pressure is primarily determined by the **protein concentration** in the interstitial fluid. - While fluid overload can dilute interstitial proteins, it generally does not directly increase interstitial oncotic pressure; rather, it might decrease it due to fluid movement. *Interstitial hydrostatic pressure* - As fluid moves out of the capillaries due to increased capillary hydrostatic pressure, the **interstitial hydrostatic pressure** will also increase. - However, the primary driving force for this change, and thus the most direct consequence of fluid overload, is the increase in capillary hydrostatic pressure. *Capillary wall permeability* - This parameter refers to the ease with which substances, including fluid and proteins, can cross the capillary wall. - Fluid overload does not typically affect **capillary wall permeability** unless there is an underlying condition causing inflammation or damage to the capillary endothelium. *Capillary oncotic pressure* - This pressure is mainly determined by the **protein concentration** within the capillaries. - In a state of fluid overload with isotonic fluids, the plasma proteins are diluted, leading to a **decrease** in capillary oncotic pressure, not an increase.

Pediatric Surgery US Medical PG Question 7: An 8-year-old boy presents to his pediatrician for a well visit. His parents state that he has been doing well in school and has many friends. The patient is a member of the chess club and enjoys playing video games. He has a past medical history of asthma which is treated with albuterol. The patient is in the 99th percentile for weight and 30th percentile for height. His temperature is 99.5°F (37.5°C), blood pressure is 122/88 mmHg, pulse is 90/min, respirations are 11/min, and oxygen saturation is 98% on room air. The patient's body mass index is 39.1 kg/m^2 at this visit. On physical exam, you note a young boy who maintains eye contact and is excited to be at the doctor's office. Cardiopulmonary exam is within normal limits. Abdominal exam reveals normal bowel sounds and is non-tender in all 4 quadrants. Neurological and musculoskeletal exams are within normal limits. Which of the following is the most likely outcome in this patient?

• A. Constitutional growth delay
• B. Precocious puberty
• C. Hypertension
• D. Slipped capital femoral epiphysis (Correct Answer)
• E. Atherosclerotic heart disease

Pediatric Surgery Explanation: ***Slipped capital femoral epiphysis*** - The patient's **obesity** (BMI 39.1 kg/m^2, 99th percentile for weight) is a significant risk factor for **slipped capital femoral epiphysis (SCFE)**, especially during periods of rapid growth. - SCFE presents with hip, groin, thigh, or knee pain and a limp, often requiring emergency surgical intervention to prevent further slippage and complications like avascular necrosis. *Constitutional growth delay* - This condition is characterized by **short stature** and delayed puberty, usually with a family history of delayed growth spurts. - While it involves growth, it does not explain the patient's obesity or increased risk of musculoskeletal complications associated with it. *Precocious puberty* - Precocious puberty is defined by the onset of secondary sexual characteristics before age 8 in girls or age 9 in boys. - While obesity can be a risk factor for earlier puberty, it is not the most immediate or likely outcome given the clinical scenario, and there are no signs of puberty mentioned. *Hypertension* - The patient's blood pressure (122/88 mmHg) is elevated for an 8-year-old and indicative of **hypertension**, a common comorbidity of obesity. - However, while present, hypertension is a *current finding* and comorbidity, not a *future outcome* in the same immediate risk category as SCFE for an obese child of this age. *Atherosclerotic heart disease* - While obesity in childhood increases the long-term risk of **atherosclerotic heart disease**, this is a chronic process that develops over many years, typically manifesting in adulthood. - It is a long-term consequence rather than the *most likely immediate outcome* during childhood, unlike conditions directly precipitated by childhood obesity.

Pediatric Surgery US Medical PG Question 8: A 3-week-old firstborn baby girl is brought to the pediatric emergency room with projectile vomiting. She started vomiting while feeding 12 hours ago and has been unable to keep anything down since then. After vomiting, she appears well and hungry, attempting to feed again. The vomitus has been non-bloody and non-bilious. The last wet diaper was 10 hours ago. The child was born at 40 weeks gestation to a healthy mother. On examination, the child appears sleepy but has a healthy cry during the exam. The child has dry mucous membranes and delayed capillary refill. There is a palpable olive-shaped epigastric mass on palpation. Which of the following is the most likely cause of this patient's condition?

• A. Failure of neural crest cell migration into the rectum
• B. Telescoping of the small bowel into the large bowel
• C. Hypertrophic muscularis externa (Correct Answer)
• D. Patent tract between the trachea and esophagus
• E. Failure of duodenal lumen recanalization

Pediatric Surgery Explanation: ***Hypertrophic muscularis externa*** - The presented symptoms, including **projectile vomiting** in a 3-week-old, **non-bilious** emesis, post-vomiting **hunger**, and a **palpable olive-shaped mass** in the epigastrium, are classic signs of **pyloric stenosis**. This condition is caused by the **hypertrophy of the pyloric sphincter's muscularis externa**. - Pyloric stenosis commonly presents between **2-8 weeks of age** and leads to an obstruction of gastric outflow, causing the characteristic vomiting and signs of dehydration like **dry mucous membranes** and **delayed capillary refill**. *Failure of neural crest cell migration into the rectum* - This describes **Hirschsprung disease**, which typically presents with **constipation**, **abdominal distension**, and a **failure to pass meconium** in the neonatal period. - While it involves GI obstruction, its symptoms and location of obstruction are distinctly different from the projectile vomiting seen in this case. *Telescoping of the small bowel into the large bowel* - This is known as **intussusception**, which usually presents with **intermittent, colicky abdominal pain**, **"currant jelly" stools** (due to blood and mucus), and a sausage-shaped abdominal mass, typically in older infants (3 months to 3 years). - The type of vomiting (often bilious) and stool characteristics are different from the patient's presentation. *Patent tract between the trachea and esophagus* - This describes a **tracheoesophageal fistula (TEF)**, often associated with esophageal atresia. Infants with TEF typically present with **choking, coughing, and cyanosis** during feeds, as well as aspiration, due to misdirection of fluid into the lungs. - The symptoms are immediate and severe with initial feeds and do not typically involve progressive projectile vomiting after several weeks of life. *Failure of duodenal lumen recanalization* - This leads to **duodenal atresia**, which typically presents with **bilious vomiting** within the first 24-48 hours of life, and the classic "double bubble" sign on X-ray. - The vomiting in this case is **non-bilious** and started later, which rules out duodenal atresia.

Pediatric Surgery US Medical PG Question 9: A 5-week-old infant boy presents to the pediatrician with intermittent vomiting for the last 2 weeks. The mother reports that the vomiting is non-bilious and immediately follows feeding. After vomiting, the baby is hungry and wants to feed again. The frequency of vomiting has been increasing progressively over 2 weeks. The vital signs are within normal limits. The examination of the abdomen reveals the presence of a firm mass of approx. 2 cm in length, above and to the right of the umbilicus. The mass is movable, olive-shaped, and hard on palpation. Which of the following is the most likely surgical treatment for this infant’s condition?

• A. Duodenoduodenostomy
• B. Pyloromyotomy (Correct Answer)
• C. Surgical ligation of the fistula and primary end-to-end anastomosis of the esophagus
• D. Diverticulectomy
• E. Endorectal pull-through procedure

Pediatric Surgery Explanation: **Pyloromyotomy** - The clinical presentation of **non-bilious projectile vomiting** in an infant, immediately after feeding, with persistent hunger, and a palpable **olive-shaped mass** in the epigastrium, is classic for **hypertrophic pyloric stenosis**. - **Pyloromyotomy (Ramstedt procedure)** is the definitive surgical treatment, which involves incising the hypertrophied muscle of the pylorus while leaving the mucosa intact, thereby relieving the obstruction. *Duodenoduodenostomy* - This procedure is typically performed to correct **duodenal atresia**, an anatomical blockage of the duodenum and presents from birth. - Duodenal atresia usually causes **bilious vomiting** and is not associated with a palpable epigastric mass. *Surgical ligation of the fistula and primary end-to-end anastomosis of the esophagus* - This is the surgical treatment for **esophageal atresia with tracheoesophageal fistula**, which would present as choking, coughing, and respiratory distress during feeding from birth. - It does not involve a palpable abdominal mass or progressive non-bilious vomiting. *Diverticulectomy* - This procedure is performed to remove a **Meckel's diverticulum**, which may present with painless rectal bleeding or intussusception, but not typically with projectile non-bilious vomiting or a palpable olive-shaped mass. - Meckel's diverticulum is a congenital abnormality that is usually asymptomatic. *Endorectal pull-through procedure* - This is the standard surgical treatment for **Hirschsprung disease**, a condition characterized by the absence of ganglion cells in the distal colon, leading to functional obstruction. - Hirschsprung disease typically presents with **constipation**, abdominal distension, and failure to pass meconium, not early-onset projectile vomiting or a palpable olive mass.

Pediatric Surgery US Medical PG Question 10: A 16-year-old man presents to the emergency department with a 2-hour history of sudden-onset abdominal pain. He was playing football when his symptoms started. The patient’s past medical history is notable only for asthma. Social history is notable for unprotected sex with 4 women in the past month. His temperature is 99.3°F (37.4°C), blood pressure is 120/88 mmHg, pulse is 117/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical exam is noted for a non-tender abdomen. Testicular exam reveals a right testicle which is elevated with a horizontal lie and the scrotum is neither swollen nor discolored. Which of the following is the most likely diagnosis?

• A. Traumatic urethral injury
• B. Seminoma
• C. Appendicitis
• D. Epididymitis
• E. Testicular torsion (Correct Answer)

Pediatric Surgery Explanation: ***Testicular torsion*** - The sudden onset of **unilateral scrotal pain** in an adolescent, accompanied by an **elevated testicle** with a **horizontal lie**, is highly suggestive of testicular torsion. The absence of scrotal swelling or discoloration in the early stages is also consistent. - Testicular torsion is a **surgical emergency** requiring prompt intervention to preserve testicular viability. *Traumatic urethral injury* - This would typically present with **dysuria**, **hematuria**, inability to void, and potentially **blood at the urethral meatus**, none of which are described. - A traumatic urethral injury often results from falls, straddle injuries, or pelvic fractures, not typically from playing football without direct trauma to the perineum. *Seminoma* - Seminoma is a type of **testicular cancer** that typically presents as a **painless testicular mass**. - It would not cause sudden, acute abdominal pain and would not manifest with an acutely elevated testicle and horizontal lie. *Appendicitis* - Although appendicitis can cause abdominal pain, the **non-tender abdomen** on examination and the specific findings on **testicular examination** (elevated testicle, horizontal lie) make appendicitis unlikely. - Appendicitis pain typically localizes to the right lower quadrant, often associated with fever, nausea, and vomiting. *Epididymitis* - Epididymitis causes **scrotal pain** and **swelling**, often with fever and **dysuria**, usually developing over days, not hours. - It is often associated with the **Prehn's sign** (pain relief with elevation of the testicle), which is usually absent or negative in torsion. The patient's sexual history might suggest an STI, but the acute presentation and examination findings point away from epididymitis.

Pediatric Surgery Flashcard 1 of 10

Question: An entire abdomen burn is _____% of the body surface area.

Answer: 18

Pediatric Surgery Flashcard 2 of 10

Question: EF < _____% and MI within _____ months are absolute contraindications to non-cardiac surgery

Answer: 35

Extra Information:  https://onlinemeded.org/spa/surgery?ref=anki 

Pediatric Surgery Flashcard 3 of 10

Question: _____ may present as a palpable, pulsatile abdominal mass that grows with time

Answer: Abdominal aortic aneurysm

Pediatric Surgery Flashcard 4 of 10

Question: _____ is a congenital hypertrophy of the pyloric smooth muscle

Answer: Pyloric stenosis

Pediatric Surgery Flashcard 5 of 10

Question: Patients who have undergone _____ surgery can sometimes manifest with symptoms of hypoparathyroidism and hypocalcemia.

Answer: Thyroid

Pediatric Surgery Flashcard 6 of 10

Question: How is a large ventricular septal defect treated? _____

Answer: Surgical closure

Pediatric Surgery Flashcard 7 of 10

Question: What is the most common pediatric elbow fracture?_____

Answer: Supracondylar fracture of the humerus

Pediatric Surgery Flashcard 8 of 10

Question: congenital pharyngo-cutaneous fistula

Answer: persistence of 3rd branchial cleft and pouch

Extra Information: fistula between tonsillar area, cleft in neck

Pediatric Surgery Flashcard 9 of 10

Question: gastroschisis

Answer:

Extra Information: visible abdominal contents of newborn; not covered by peritoneumextrusion of abdominal contents through abdominal folds

Pediatric Surgery Flashcard 10 of 10

Question: What are the 5 transesophageal embryological anamolies?

Answer: - pure EA - pure TEF - proximal TEF - distal TEF - double TAF