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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

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11 FOREIGN BODY ASPIRATION Common in children 1 - 3 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 )

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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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