DrAlex_76
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A previous healthy 6 month old boy is brought in because of 12 hour history of intermittent episodes of inconsolable crying associated with drawing up the leg. He has reddish and mucoid diarrhea over the past 6 hours and for the past 3 hours, he has been somnolent. On exam, he sleepy but arousable . His temp = 38 , BP = 90/55, P = 140 , RR = 38. He cried when abdomen is palpated and a mass is felt in the right lower quadrant. His WBC = 12,400, ( 50 % seg N, 8 % band, 1% eosinophils, 40% lym ) Serum electrolytes and XR are all normal. What is the most likely diagnosis ?
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| jmkhanzada
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PROBABLY .........INTUSSUSCEPTION............AS HE IS 6 MONTH OLD......?
BUT LOCATION OF MASS SHOWS........MECKEL DIVERTICULUM ////////?
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| DrAlex_76
Forum Guru
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Meckel diverticulum ------> mostly comes with painless blood stool and age from 2 - 4 years old!
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| jmkhanzada
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yup u r right ...........but some time meckel self get intussuscept,,,,,,,,,,,,,,still confusing...........regarding age and site of mass..........not getting it..
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| nightflight1945
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DrAlex_76 wrote:
A previous healthy 6 month old boy is brought in because of 12 hour history of intermittent episodes of inconsolable crying associated with drawing up the leg. He has reddish and mucoid diarrhea over the past 6 hours and for the past 3 hours, he has been somnolent. On exam, he sleepy but arousable . His temp = 38 , BP = 90/55, P = 140 , RR = 38. He cried when abdomen is palpated and a mass is felt in the right lower quadrant. His WBC = 12,400, ( 50 % seg N, 8 % band, 1% eosinophils, 40% lym ) Serum electrolytes and XR are all normal. What is the most likely diagnosis ?
A typical case of intussusception
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| omz2302
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I have to agree with nightflight. The intermittent episodes plus the knee raising (usually kids get into a fetal position when they have the episode) plus the EXACT description of current jelly stool. Its pretty pathognemonic for intussusception. Also, even if its due to Meckels diverticulum, this is a board question. Meckels would not be an answer choice because theres no diagnosis for it. It just happens to be found on surgical exploration for something completely different or a complication caused by it (intussusception). Meckels diverticulum is an anomaly, its not a pathology....well, until something goes wrong with it.
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| nightflight1945
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| bioguy
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"for the past 3 hours, he has been somnolent. On exam, he sleepy but arousable"
any specific reason to be alarmed? is his BP 90/55 ok? is pain relieved by diarrhea and so after poopy his is sleepy?
___________________
ARE YOU A ROCKNROLLA?
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| nightflight1945
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bioguy wrote:
"for the past 3 hours, he has been somnolent. On exam, he sleepy but arousable"
any specific reason to be alarmed? is his BP 90/55 ok? is pain relieved by diarrhea and so after poopy his is sleepy?
For a 6 month old infant this BP= 90/55 is absolutely normal .
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| ngaybinhyen
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typical case, guys
in this case, the kid probably needs laparotomy
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| Eagle_303
Forum Guru
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Current Jelly Stools = Intussusception
Current jelly sputum = Klebsiella Peneumonia
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