PEDIATRIC COLONOSCOPY: INSTRUCTION FOR BOWEL PREPARATION Proper bowel preparation prior to colonoscopy is VERY IMPORTANT. If your child’s bowels are not cleaned out well enough, the procedure may have to be canceled or rescheduled. If you are unable to follow the instructions or have any questions, it is better to call your physician to clarify your doubts. Give the child a liquid or semisolid diet (water, milk, dal, fruit juice, soup or broth, khichri, dahlia) from 2 days prior to the procedure. Try to avoid solid food. On the day before the procedure: Prepare PEGLEC solution [Polyethylene glycol with electrolytes for oral solution (137.15g); mix the whole packet with 2 liters of drinking water; Additional flavor (pineapple or orange) available within the packet can be added for taste] Administer the PEGLEC solution from 3 pm onwards; Give 250 ml orally every hour (for infants: 30ml/kg/hour); it will result in frequent defecation with loose stools; Continue giving it till stool b...
PORTAL HYPERTENSION in Children Q1: What is portal hypertension? portal venous pressure > 12 mm Hg or portal pressure gradient (between IVC and portal vein) >5 mm Hg Currently, the most commonly used parameter is the Hepatic Venous Pressure Gradient (HVPG) [the difference between the wedged (WHVP) and the free hepatic venous pressures] Pressure = Flow x Resistance (Resistance increases due to active myofibroblast or vascular smooth muscle cells in intrahepatic veins; and overall liver disease; Flow increases due to splanchnic arteriolar dilatation by release of endogenous vasodilators) (portal veins start and end as capillaries and no valves; please vide the picture on porto-caval anastomosis sites) Q2: What are the 3 key components of portal hypertension? Splenomegaly Ascites Varix (Esophageal varices/ Gastro-esophageal varices/ Isolated gastric varices/ Rectal varices) Q3: What are the causes of portal hypertension? [Here is a li...