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Surgery Pediatric Surgery 0bdd7be8

A 7-day old infant presents with bilious vomiting and gross abdominal distention with absent bowel sounds. X ray abdomen shows multiple gas filled loops. Diagnosis is?

A
Hirschsprung disease
B
Congenital Hyperophic pyloric stenosis
C
Duodenal atresia
D
Malrotation of gut
High-Yield Explanation
Hirschsprung disease: No passage of meconium within 24 hours Abdominal distension Involvement rectum > sigmoid No vomiting Congenital Hyperophic pyloric stenosis: Misnomer (hyperophic pyloric stenosis is acquired) Therefore, known as infantile hyperophic pyloric stenosis Age of presentation is 4th to 6th week after bih Non bilious vomiting Duodenal atresia: Symptomatic just after bih Bilious vomiting Double bubble sign (therefore multiple gas filled loops are not seen) Malrotation of gut: Bilious vomiting Abdominal distention Multiple gas filled loops

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