7 days mch with near term iugr admitted with vommitings and alterd aspirat cbc crp sr electrolytes was normal suggestions please...


it's Pyloric stenosis. surgical exploration is required.

duedenal atresia

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Obviously surgical abdomen with perforation /peritonitis/pneumoperitonium/?sepsis.. With this gross pneumoperitonium.. I don’t appreciate..pnematosis intestinalis or pneumobiliarygram or pneumoperitonium portogram...or pneumomediastinum.. 7 day old IUGR but may not be ICN Baby..neither premature( does not rule out NEC..)..possibly malroratation/mid gut volvulus/more likely..perforated intusussception rate...Exploration is definitive. Pyloric stenosis should not even cross Physicians mind(sorry)..Here primary aim is management ...ABCD...VS missing.. Temp/RR/HR/BP/pulse ox/Capillary refill... ABG for PH/Co2.This is critical baby.. If not admission..will certainly progresses.. if not managed aggressively cardiorespiratory status...X-ray does not even show NG tube for decompression/continuous aspiration.. aggressive volume management and may be Intubation and ventilation...Blood culture /urine culture are important.. None the less Broad spectrum antibiotics for gut flora coverage...We May have differences in agreement with final diagnosis...but not with perforation and definitely not with Stabilisation and basic initial management Thanks

it appears to be intestinal obstruction. now weder abdominal distension is present or not.if it is absent it is likely to be midgut' malrotation.

gastric outlet obstruction. likely pyeloric stenosis..

Pneumoperitoneum & free gas on x ray

Duodenal atresia.

sir, duodenal atresia has double bubble sign, isnt it?

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volvulus neonatarum

single bubble sign on x ray- pyloric stenosis

with pneumoperitoneum

pyloric stenosis

there is evidence of free gas in the x-ray. this baby should be operated, as soon as stable.

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