Episode 19 Part 2: Pediatric Gastroenteritis, Constipation and Bowel Obstruction

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 7 January 2012

⏱️ 99 minutes

🔗️ Recording | iTunes | RSS

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Summary

In Part 2 of this pediatric abdominal pain Episode - Pediatric Gastroenteritis, Constipation & Bowel Obstruction, Dr. Anna Jarvis, Canada's "mother of pediatric emergency medicine" and Dr. Stephen Freedman, one of Canada's pre-eminent researchers in pediatric GI emergencies, discuss the assessment, work-up and treatment of pediatric gastroenteritis, with particular attention to gastroenteritis & acute abdomen mimics, how best to assess hydration status, the nuances of the use of ondansetron and the prose and cons of various rehydration methods. A detailed discussion of the most common and lethal causes of acute abdomen bowel obstruction in pediatrics follows, including intussesception and midgut volvulus. Finally, the differential diagnosis and best management of the most common cause of pediatric abdominal pain, constipation, is reviewed.

Transcript

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0:00.0	Welcome to Emergency Medicine Cases.com.
0:05.0	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC Studios in Toronto.
0:15.9	Welcome to Part 2 of Episode 19 on Pediatric Abdominal Pain.
0:20.4	We have with us Dr. Anna Jarvis, who was an
0:22.4	emergency physician at the hospital for sick children in Toronto from 1997 to 2010. She's a full
0:27.8	professor at the University of Toronto and the Associate Dean of the Office of Health Profession
0:31.8	Student Affairs. She also created, implemented, and supervised the Department of Pediatrics
0:36.2	Clinical Fellowship Program in Pediatric Emergency Medicine for the last 13 years. Dr. Stephen Friedman is an emergency
0:42.1	physician at the Hospital for Sick Children in Toronto and an assistant professor at the University
0:46.2	of Toronto. He completed his Pediatric Emergency Medicine Fellowship, a Children's Memorial
0:50.5	Hospital in Chicago, and a Master's of Science in Clinical Investigation at Northwestern University. He's a clinician investigator in the Division of Emergency Medicine
0:58.4	at U of T and an Associate Scientist in Child Health Evaliative Sciences. In this second part of our
1:04.5	program on pediatric abdominal pain, we're going to go on to case number two. And here it is.
1:10.7	Our second case is that of a seven-year-old
1:13.1	boy who presents to the ED at 9 p.m. with a history of diarrhea and fever for two days, as well as
1:18.4	vague abdominal pain. On further questioning, he has no travel history. His immunizations are up to
1:23.6	date. There's no viral contacts and he's otherwise healthy on no medications. He vomited
1:28.4	once that morning and has no urinary symptoms, no URI symptoms, or rash. On exam, his vital signs are
1:35.3	normal except for a temp of 38-1. His abdomen is soft with slight, diffuse tenderness and no
1:41.0	peritoneal signs. The rest of his exam is normal. A urine dip is normal.
1:46.0	A stool for CNS is sent off and the boy is rehydrated with PD light in the ED and a diagnosis
1:51.7	of gastroenteritis is made. Sound familiar? Well, this is the exact same case that we talked about
	...

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