Intussusception: The Daily PANCE Blueprint
A 2-year-old male presents with episodes of inconsolable crying, vomiting, and crampy abdominal pain. On exam, a sausage-shaped mass is felt in the right abdomen, and his stool is bloody and mucus-filled. Which of the following is the most likely diagnosis?
A. Meckel’s diverticulum
B. Intussusception
C. Pyloric stenosis
D. Volvulus
E. Diverticulitis
Answer and topic summary
The answer is B. Intussusception
Intussusception is a condition that happens when part of the intestine telescopes into itself. It is one of the most common abdominal emergencies in infants and toddlers (~2 years old and younger). The most common location for intussusception to occur is the ileocolic region (junction of the ileum and large intestine/cecum). The etiology is unknown most of the time; however, there is an association between intussusception and viral infections (and also previous forms of the rotavirus vaccine). Clinical features include: inconsolable crying, crampy abdominal pain, vomiting, sausage-shaped abdominal mass, grossly bloody stool (“currant jelly stool”). Ultrasonography is the diagnostic test of choice (100% sensitive and specific). The mainstay of treatment is non-operative reduction using pneumatic or hydrostatic pressure by enema (in stable patients without evidence of perforation or shock).
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Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
