Paeds Cases · gastroenterology-hepatology-and-nutrition
Counsel parents of a neonate with suspected midgut volvulus — OSCE
OSCE communication and shared-planning station: breaking the news to the frightened parents of a three-day-old neonate whose sudden bilious vomiting has led to an urgent upper gastrointestinal contrast study confirming malrotation with midgut volvulus, explaining the danger to the blood supply of the bowel in plain language, outlining the need for an emergency operation called the Ladd procedure, and giving honest prognostic framing while addressing fear and the speed of events.
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You have eight minutes to counsel the frightened parents of a three-day-old neonate whose sudden bilious vomiting has led to an upper gastrointestinal contrast study confirming malrotation with a midgut volvulus, and who is now being prepared for an emergency Ladd procedure. Use a structured, honest and empathic approach that names the urgency without overwhelming the family, and that builds a shared plan. [1] [2]
References3ShowHide
- [1]Godbole P; Stringer MD Bilious vomiting in the newborn: How often is it pathologic? J Pediatr Surg, 2002.PMID 12037761
- [2]Lampl B; Levin TL; Berdon WE; Cowles RA Malrotation and midgut volvulus: a historical review and current controversies in diagnosis and management. Pediatr Radiol, 2009.PMID 19241073
- [6]Ingoe R; Lange P The Ladd's procedure for correction of intestinal malrotation with volvulus in children. AORN J, 2007.PMID 17292689