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Pneumothorax & pneumopericardium. Pneumothorax, pneumopericardium pneumoperitoneum, subcut. emphysema.

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Presentation on theme: "Pneumothorax & pneumopericardium. Pneumothorax, pneumopericardium pneumoperitoneum, subcut. emphysema."— Presentation transcript:

1 Pneumothorax & pneumopericardium

2 Pneumothorax, pneumopericardium pneumoperitoneum, subcut. emphysema

3 Pulmonary interstitial emphysema

4 CATHETER AND TUBE POSITION 1. ENDOTRACHEAL TUBE : 1 cm below vocal cord & 2 cm above carina 2. NASOGASTRIC TUBE : In stomach 3. UVC : in IVC or RA proper 4. UAC : in thoracic aorta below level of DA ( T4 ) and above origin of celiac artery ( T11 )

5 UAC at T3- 4 level

6 UAC tip is at T11

7 UVC tip is in portal vein

8 RESPIRATORY DISTRESS IN NEWBORN SURGICAL CAUSES DIAPHRAGMATIC HERNIA Common on left side Multiple lucencies or cysts ( bowel loops ) in the chest Shifting of heart and mediastinum to the other side Decreased bowel gas or gasless abdomen



11 FOREIGN BODY ASPIRATION Common in children years old Tracheal obstruction Bronchial obstruction Incomplete - check valve : Air trapping Complete : Atelectasis S/S : Dyspnea, hyperpnea, cough, +/- Hx of FB aspiration

12 F 11 mo, 1

13 IiInInspiration film

14 Expiration film, more air trapping in right lung

15 Scope : peanut in Rt.main bronchus Post F.B. removal film

16 F 4mo, cough, 1 wk

17 Post F.B.removal

18 Alimentary Tract Disease in Children

19 ALIMENTARY TRACT OBSTRUCTION IN NEWBORN Normal abdominal bowel gas pattern : Polygonal pattern Stomach : immediate after birth Small bowel : within 3 hours Colon : within 5 hours Rectum : within 6-8 hours Prone film to demonstrate air in rectum ( R/O obstruction ) Upright or left lateral decubitus film to demonstrate free air

20 Normal bowel pattern = polygonal

21 ESOPHAGEAL ATRESIA ( EA ) MC = proximal eso. atresia with distal TEF High incidence of associated anomalies : VACTERL ( V-vertebral, A-anorectal, C-cardiovascular, TE-tracheoesophageal,R-renal, L-limb )



24 GASTRIC OUTLET OBSTRUCTION IDIOPATHIC HYPERTROPHIC PYLORIC STENOSIS S/S : Non-billous vomitting Onset ~ 1 month old Minimal upper abdominal distension +/-palpable mass ( olive ) at epigastrium

25 IDIOPATHIC HYPERTROPHIC PYLORIC STENOSIS ( IHPS ) X-RAY FINDINGS : Plain film : Gastric dilatation with large amount of air/fluid content, Decreased small bowel gas US : Elongation with thickening of muscle wall of pyloric canal UGI : Narrowing and elongation of pyloric canal String sign Muscle indentation on lumen of stomach and duodenum shoulder sign

26 M 5 mo, vomiting for 5 d.

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