keepgoing
Forum Guru
Topics: 63
Posts: 1,682
|
A 3 yo child presents with an abrupt onset of colicky pain in the mid-epigastrium and bloody stools.physical examination shows an oblong mass in the mid-epigastrium.the patient most likely has
A. diverticulitis
B.a meckel diverticultis
C. an intussusception
D. necrotizing enterocolitis
E. a volvulus
|
| dncosta
Licensed, finally
Topics: 19
Posts: 604
|
C, the clue is the colicky word, that would not be typical for Meckel. The others are less likely for epidemiological reasons
|
| silver
Forum Guru
Topics: 21
Posts: 774
|
C. an intussusception
___________________
Every disaster hides an opportunity.
|
| Medusin
Forum Elite
Topics: 17
Posts: 279
|
Agree C.
___________________
What Starts Here Changes The World
|
| new_n_lost
Politically InCorrect
Topics: 653
Posts: 6,086
|
Just for the Heck of it Meckel's Diverticulitis
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| Ujk
Forum Guru
Topics: 42
Posts: 446
|
CCCCCC
___________________
“When a person really desires something, all the universe conspires to help that person to realize his dream.”
|
| inkspot
Forum Guru
Topics: 26
Posts: 559
|
it is C ! Intusseption causes bloody diarrohea. I have seen one case during my internship! its usually after diarrohea and on PR examination ileo cecal intusseption was felt.
the question is vauge! diverticulosis causes blood loss! but its with left sided pain and also in elderly.
meckels can be interesting! it does bleed! specially when there is forign tissue to it like gastric (christoma) but colicy is buzz word here.
if color of stool was mentioned the question could have been more clearer! hematochazia vs melena
___________________
Aagae Aagae Dekho hota hai kiya !!!
|
| keepgoing
Forum Guru
Topics: 63
Posts: 1,682
|
yes the patient has (C)an intussuception which refres to the telescoping of one segment of proximal bowel,usually terminal ilieum.it is mainly achildhood disease,alhough it may occur in adults too.the pathogenesis in children is often associated with adenovirus infection,which produce hperplasia of payers patches in terminal ilieum,these project into lumen and serve as nidus for intusscseption of terminal ilieum(intussusceptum) into cecum(intussucipiens)when advancing peristaltic wave hits one of these mounds.Lymphoid hyperplasia of peyer patches also occur during normal weaning process when child is exposed to any new food antigen.As arule in children intussusception is not associated with pathological lesions where as in adults it is most commonly associated with polyps or cancer. The clinical presentation is combination of signs of obstruction (colicky abd pain) and vascular compromise as the mesentry is pulled along with small bowel.The classical presentation involves1.sudden onset of coliky pain,2 abdominal distention, 3.passage of "cuurant jelly" stools cauesd by vascular compromise of mucosa with subsequent ischemic necrosis.
Diverticulitis is uncommon in children,b/c majority of the cases are acquired in long term increase in intraluminal pressure caused by constipation with herniation of mucosa and submucosa through area of weakness.
Meckels diverticulitis is most common cause of GI bleeding in children but it is not usually associated with abdominal mass.
Necrotizing EC is most common acquired GI emergensy in NEWBORNS.
Volvulus is twisting of bowel around its mesentric rootgiving signs of combination of obstruction and infarction.it is uncommon in children.
|
|
| |
| | | | | | | | |
