smitha
Forum Elite
Topics: 53
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CASE: A neonate doesn't pass any meconium during the 1stday of life .Onday 2 he's brought for evaluation coz of repeated green vomiting and progressive abdominal distension.X ray films of the abdomen show multiple dilated loops of small bowel and no gas in the colon.A contrast enema shows a normally positioned microcolon, and the contrast material refluxes freely into the small bowel, filling some of the more distal distended loops.Exploratory laparotomy is done. There is no malrotation, the small bowel doen't have any atretic or obstructed segments, and there is no inspissated meconium in it.Which of the following is most appropriate next step in management?
a.Diverting ileostomy
b.Diverting ileostomy and appendectomy
c.Transverse loop colostomy
d.Total colectomy
e.Total proctocolectomy and permanent ileostomy
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| shatal
Forum Newbie
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Diverting ileostomy
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| puneet
Forum Newbie
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the correct answer is b ie . ileostomy with appendectomy.
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| rome
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smitha wats the right answer...?????
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| zaki
Forum Guru
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a.Diverting ileostomy
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Maverick
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| helpful
Forum Junior
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a.Diverting ileostomy
I think I am right smitha. What is your choice?
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| mkodumagulla
Forum Senior
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It is B.Ileostomy with Appendictomy.
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| mkodumagulla
Forum Senior
Topics: 12
Posts: 99
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It is B.Ileostomy with Appendictomy.
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| usmledoctor1
Forum Junior
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Ileostomy with Appendictomy appendix will be used for histological diagnosis of hirsprung ds
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| premonition
Forum Elite
Topics: 48
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I had Hirschsprungs in mind too.
Hey but USMLEDOC do you really think the appendectomised appendix will be used for the diagnosis of Hirschsprungs?
Woudnt it be better to do rectal biopsy from elsewhere? I doubt if the appendectomy is the best possible way for a diagnosis! Could someone clarify please.
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| khrys
Forum Newbie
Topics: 8
Posts: 32
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It is a question from Kaplan q book.
Correct answer is diverting ileostomy and appendectomy. Appendix will be used to make Dx of Hirshprung's. I did not know it could be used for this purpose either.
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