What is the key marker in pediatric GI?
Growth vs. development of puberty.
What is the key cause of caloric deprivation in children?
Not enough fat. Carbohydrates are not as good as fat.
What is the pediatric differential for GI pain, early satiety or anorexia?
PUD, Celiac disease, IBD, food allergy, or parasites.
What tests are part of a pediatric malabsorption workup?
Calorie count, guiac test, 72 hour fecal fat test, serum D-xylose test, CBC, chem screen, CRP, ESR, celiac antibodies.
What does serum D-xylose test?
Gut absorption to rule out enteric disease and zero in on pancreatic insufficiency.
When do you get both abnormal fecal fat and abnormal D-xylose test?
When do you get just abnormal fecat fat, but normal D-xylose?
Celiac disease/short gut syndrome.
What is a muco-lytic agent?
How does CF sometimes present?
Meconium ileus, distal intestinal obstruction syndrome, rectal prolapse (but most patients with rectal prolapse do not have CF), pancreatic insufficiency, pancreatitis, hepatobiliary disease.
Does CF cause pancreatitis?
Yes, in some patients with pancreatic sufficiency. How crazy!
What is EHBA?
Extra-hepatic biliary atresia that can lead to failure to thrive with jaundice with unknown etiology.
What is a HIDA?
Hepatobiliary scan that can diagnose EHBA.
What is the Kasai procedure?
Portoenterostomy = excision of the obliterated extrahepatic ducts and attachment of small bowel to the porta hepatis.
What is the most common cause of constipation?
What must be rules out with pediatric constipation?
Hirschprung's disease, absence of ganglia cells in small bowel lead to passive contraction.
What is a sign of Hirschprung's disease on barium enema?
What is the most critical complication of Hirschprung's disease?
Distension, bacterial translocation, and enterocolitis.