Clinical Diagnosis: Acute Intussusception in an Infant
The clinical presentation strongly suggests acute intussusception based on the characteristic symptoms and examination findings in an infant.
Key Clinical Indicators
- Age and Symptoms: An eight-month-old male infant experiencing recurrent episodes of screaming and drawing up of legs indicates severe, intermittent abdominal pain, a hallmark of intussusception.
- Intermittent Distress: The observation that the child appears listless between attacks signifies the cyclical nature of the pain associated with intussusception.
- Abdominal Examination: The finding of an empty right iliac fossa is significant. It suggests that the intussuscepted bowel segment, typically starting at the ileocecal junction, has telescoped into the colon or moved proximally.
- Rectal Examination: The presence of blood-stained mucus on the examining finger, often termed "currant jelly stool," is a classic and highly specific sign of intussusception, caused by ischemia and sloughing of the engorged intestinal mucosa.
Differential Diagnosis Consideration
While other abdominal emergencies can occur in infants, they present differently:
- Volvulus (Caecal/Midgut): Often presents more acutely with persistent, severe pain, bilious vomiting, and signs of complete bowel obstruction. Bloody stools are typically a later sign, if present.
- Rectal Prolapse: This condition involves the protrusion of the rectal lining through the anus. It is usually visually apparent and does not typically present with the described colicky pain pattern or internal mass migration indicated by the empty RIF.
Conclusion
The combination of the infant's age, symptoms of severe intermittent colicky pain, characteristic "currant jelly" stools, and the specific abdominal finding (empty RIF) strongly points towards acute intussusception as the most probable diagnosis.
Important Questions from Intestines
- An eight month old male child is brought to the emergency with recurrent episodes of screaming and drawing up of legs. The child appears to be listless in between the attacks. Local examination of abdomen reveals feeling of emptiness in the right iliac fossa and blood stained mucus is found on the finger on per rectal examination. The most probable clinical diagnosis in this child is
Which of the following statements regarding Ogilvie's syndrome are correct?
1. It presents as acute large bowel mechanical obstruction
2. Marked caecal dilatation is a common feature on X-ray abdo- men
3. Caecal perforation is a well recog- nized complication of this condi- tion
4. Intravenous Neostigmine is used for the treatment of this condition
Select the correct answer using the code given below :
- Among the extra intestinal manifesta- tions of Crohn's disease which one of the following is related to the disease activity?
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- Which of the following are the intraoperative features of viable small bowel?
1. Visible peristalsis
2. Flabby intestinal musculature
3. Shiny appearance of small bowel wall
4. Visible pulsation in the mesenteric artery
Select the correct answer using the code given below.
