A. Esophageal Atresia B.

Upper GI Hernias
- incomplete formation of the esophageal -Cutaway View of Hiatal Hernia
lumen, resulting in the proximal (upper)
esophagus forming a "blind pouch". - Protrude to the hiatus

5 usual types 4 TYPES

Type A- Isolated oesophageal atresia 8% Type 1 - Slide (cause gerg)

Type B- Proximal fistula Distal atresia 1% Type 2 -paraesophageal hiatal hernia

Type C- Proximal atresia Distal fistula 85% (most Type 3- Combined type 1 and 2
common) Type 4- complex paraesophageal hiatal hernia
Type D- Double fistula with oesophageal atresia (whole stomach is pushed up into the chest)
1%
Type H- Isolated fistula H-type 4% Assessment
-heartburn (after meal)
Assessment -abdominal pain
-Hydramnios -burping or hiccups
-Prematurity -vomiting or spitting up
-Other possible congenital anomalies: verbal, -coughing or hoarseness
anal, cardiac, tracheoesophageal, renal, and
limb anomalies -fullness of bloating

- Diagnosis: X-ray, Barium Swallow, or Bronchial -dark bowel movements

Endoscopy -breathing problems

Therapeutic Management Diagnosis

-Upright position, 60 degree angle -Upper GI Series Test
-Gastronomy with tube -Endoscopy
-Iv fluids and parenteral nutrition -Esophageal manometry
-IV meds to reduce stomach's acid -Esophageal pH monitoring
-Antibiotic
-Surgery: Closing the fistula and anastomosis of Therapeutic Management
the esophageal segments.
-Medicines to relieve heartburn
-7 to 10 days (observe)
-Surgery: Fundoplication - The fundus is
wrapped around the back side of the
esophagus. The wrap is secured with sutures to -Oral rehydration
anchor lower esophagus below diaphragm
-IV Fluid replacement
-Antibiotics, if bacteria are the cause
C. Irritable Bowel Syndrome
-Antiparasitic, if parasites are the cause
Assessment
-Abdominal Pain
E. Appendicitis
-Altered bowel habits (diarrhea, constipation or
both) -Inflammation of the appendix
-Occurs most frequently in school-aged children
and adolescents
Etiology: unknown

Possible cause: Generally Obscure; Upper

Therapeutic Management respiratory or other body infection, fecal
material
-Antidepressants
-Anticholinergics
Assessment
-Antibiotics
-Anorexia
-Nausea and vomiting
D. Infectious Gastroenteritis
-Pain or Tenderness at the right lower quadrant
-intestinal infection caused by virus, bacteria (McBurney's Point)
and parasites. Also called as stomach flu
-Elevated body temperature
-Leukocytosis
Possible Cause:
-Rebound Tenderness (Pain is absent in
-Escherichia coli infection pressure)
-Campylobacter infection -Hypoactive Bowel sounds (ruptured appendix)
-Cryptosporidium infection -CT Scan: Swollen appendix
-Giardiasis
-Salmonellosis Therapeutic management
-Shigellosis -Elective laparoscopic appendectomy
-Viral gastroenteritis

F. Inflammatory bowel disease

Therapeutic Management - Ulcerative Colitis - large intestine and rectum
-Plenty of fluids are affected; not patchy
-Crohns disease - inflammation is happened in -Blood tests
lining of Digestive tract (small intestine);patches
that are next to areas of healthy tissue
Therapeutic Regimen

Causes -Types of common medications to treat IBD:

-Weakened Immune system - 5-aminosalicyclic acids

-Environmental triggers (virus or bacteria) -immunomodulators

-Genetic Component -corticosteroids

-Biologics (divers group of medicines)

Assessment -Surgeries to remove damaged portions of the

gastrointestinal tract
-Persistent diarrhea
-Abdominal pain
G. Volvulus with Malrotation
-Rectal bleeding/bloody stools
-Volvulus is a twisting of the intestine
-Weight loss
-leads to obstruction of the passage of feces and
-Fatigue to compromise of the blood supply to the loop
of intestine involved.

Complications
Assessment
-Colon Cancer
-Intense crying and pain
-Skin, eye and joint inflammation
-Pulling up the legs
-Medication side effects
-Abdominal distention
-Primary sclerosing cholangitis
-Vomiting(30mins or an hour after eating)
-Blood clots
-Lower Barium Xray (diagnosis)
-Severe dehydration

Therapeutic Management
Diagnosis
-Surgery: Bowel resection with anastomosis.
-a combination of endoscopy (Crohn's Disease)
or colonoscopy (ulcerative colitis) and imaging
studies, such as:
H. Celiac Disease
-Contrast radiography
Assessment
-Magnetic resonance imaging
-An immune-mediated abnormal response to
-Computed tomography gluten
-Stool samples
-when children with the disorder ingest gluten, * Passive artificial immunity: immune globulin
flattening of the fingerlike projections (villi) of
the small intestine occurs, preventing the
absorption of foods Hepatitis B
*Causative agent: Hepatitis B Virus (HBV)
-If left undiagnosed: steatorrhea, failure to * Incubation period: 120 days on average
thrive, and malnutrition.
* Period of communicability: Later part of
incubation period and during the acute stage
Assessment * Mode of transmission: Blood and body fluids
-Poor growth * Immunity: one episode includes immunity for
-Bulky stools the specific type of virus

-Malnutrition * Active artificial immunity: HBV vaccine

-Distended abdomen * Passive artificial Immunity: Hepatitis B

immune serum globulin
-Anemia

Hepatitis C,D, and E

Diagnosis: analysis of antibodies against gluten
-Hepatitis C virus (HCV) is a single-strand RNA
(endomysia antibody, tissue transglutaminase is
obtained) virus
-MOT is blood and body fluids
-Hepatitis D virus (HDV), or the delta form, is
Therapeutic Management
similar to HBV in transmission
-Gluten-free diet for life
-The R form of hepatitis is enterically
-Correction of any vitamin and mineral transmitted similarly to hepatitis A
deficiencies

Assessment
I. Hepatitis A
-Increased Liver Enzymes: ALT and AST, and
* Causative agent: Hepatitis A Virus (HAV) alkaline phosphatase levels
* Incubation period: 25 days on average -Hepatitis A: headache, fever, and anorexia,
jaundice
* Period of communicability: 2 weeks preceding
onset of symptoms - Hepatitis B: generalized aching, right upper
quadrant pain, pruritus (itching) and headache,
* Mode of transmission: Oral-fecal route accompanied by a low-grade fever; dark-colored
* Immunity: One episode includes immunity for urine, jaundice of the sclera, generalized
the specific type of virus jaundiced, white or gray stool.

* Active artificial immunity: HAV Vaccine

Therapeutic Management
-hepatitis B vaccine -shallow excavation which is form in a mucosal
wall of the stomach
-Pregnancy Screening for HBsAg
- untreated: bowel or stomach perforation
-HBIG
-No sharing of needles (Hepatitis B , C and D)
Assessment:
- Hepatitis A Vaccine
-Neonate: hematemesis or hematochezia,
-Hand hygiene & infection control precautions respiratory distress, abdominal distention,
-Proper disposal of feces vomiting, and if extensive, cardiovascular
collapse
-Good caloric intake, low-fat diet
-Toddler: anorexia or vomiting, and bleeding
-Preschool: localized pain; gnawing or aching
J. Pyloric Stenosis pain in the epigastric area, vomiting, gastric
-Thickened muscle tenderness; endoscopy is the most reliable
diagnostic test
-Narrow opening between stomach and
duodenum
-Cause is unknown Therapeutic Management
-Antibiotic: Amoxicillin and Clarithromycin

Assessment -PPI: Omeprazole

-Projectile vomiting (Immediately after each

feeding) L. Short Bowel/Short Gut Syndrome
-Vomitus has a sour smell
-Excessive drooling, or chewing on the tongue Assessment
-Signs of dehydration: dry mucous membrane of -Diarrhea: dehydration, malnutrition, and
the mouth, sunken fontanelles, fever, decreased weight loss
urine output, poor skin turgor, and weight loss
-Bloating, cramping, fatigue, or feeling tired,
-Alkalosis foul-smelling stool, heart burn, too much gas,
-Hypocapnea vomiting, weakness

Therapeutic Management Therapeutic Management

-Pyloromyotomy (perform before hypoglycemia) -Ensure adequate hydration and proper intake
of essential vitamins and minerals
-Correction of electrolyte imbalance; IV fluid
(isotonic or 5% glucose in saline) -TPN

K. Peptic Ulcer Disease M. Meckel's Diverticulum

Assessment
-a small outpouching extending from the wall of
the intestine
-the pouch is a remnant of tissue from the
embryonic development of the digestive system
-contains some misplaced gastric mucosa
-Painless, tarry (black) stools or grossly bloody
stools
-Bowel obstruction
-Diagnosis: Meckel scan

Therapeutic Management
-Laparoscopy exploration and removal of the
vestigial structure