A 3 Week Old Child Presents With Intermittent Swelling At The Umbilicus, Covered With Skin. It Becomes Quite Large On Crying And Makes The Parents Concerned About Rupture. The Lump Often Gurgles When Compressed But Doesnt Seem To Bother The Infant. Is This Lesion Dangerous, And What Is The Natural History? Is Surgery Needed? Why Is There A Hole In The Abdominal Wall?

2000+ questions in this practice test set.

1. A 3 Week Old Child Presents With Intermittent Swelling At The Umbilicus, Covered With Skin. It Becomes Quite Large On Crying And Makes The Parents Concerned About Rupture. The Lump Often Gurgles When Compressed But Doesnt Seem To Bother The Infant. Is This Lesion Dangerous, And What Is The Natural History? Is Surgery Needed? Why Is There A Hole In The Abdominal Wall?

Opioid use
This lesion is an umbilical hernia and it is not dangerous. -these are usually treated conservatively for up to 3 years because spontaneous fascial covering over the umbilical fibromuscular ring eventually develops in most (usually by 12 months. It is important to reassure the parents of this and that the skin never ruptures even though it stretches. -surgery is only needed if it doesnt spontaneously resolve after the age of 3. -the hole in the abdominal wall is from incomplete closure of the fibromuscular ring after the cord dries up.This Delayed contraction allows the peritoneum and abdo contents to bulge throught the hole. "
Stool o&p or sample of duodenal fluid by string test
Closure of 3 systemic-pulmonary shunts= foramen ovale, ductus venosis and ductus arteriosis- occurs with the closure of the umbilical arteries and veins (loss placenta at birth) and the fall in pulmonary vascular resistance and right sided pressure. The function of the placenta is replaced as the gut returns nutrient value to the right side of the heart via the portal vein, while the lungs return oxygenated blood to the left side of the heart via the pulmonary vein.