The line diagram shows the cross-section of bowel intussusception. The part marked with an asterisk is called as
intussusceptum
The correct answer is intussusceptum. In intussusception one segment of bowel telescopes into the lumen of the adjacent distal segment. The proximal, invaginating (inner) segment drawn inwards along with its mesentery and mesenteric vessels is the intussusceptum, seen on cross-section as the inner double-walled tube marked by the asterisk. Because its mesentery is dragged in, venous congestion, oedema, bleeding (red-currant jelly stool) and finally gangrene occur.
Apex is only the leading tip of the intussusceptum, its most distal point of advance, not the whole inner tube. Base or neck is the junction where the intussusceptum bends back on itself, the point of entry into the outer tube. Intussuscipiens is the outer, receiving segment that ensheathes the invaginated portion, so it forms the outermost layer, not the asterisked inner one.
Key point: Intussusceptum goes IN, intussuscipiens RECEIVES. Ileocolic is commonest in children (idiopathic, hypertrophied Peyer patches), while in adults a pathological lead point such as a tumour must be excluded.
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?
Which of the following statements with regard to Enteric perforation are correct?
1. Salmonella typhi is the causative organism for Enteric fever
2. Enteric perforation characteristi- cally occurs during third week of illness
3. Typhoid ulcers are placed trans- versely to the long axis of the gut
4. Terminal ileum is the most common site for enteric perfora- tion
Select the correct answer using the code given below :
- A 35 year old male patient with enteric fever presents to the emergency with sudden onset of generalised abdominal pain, abdominal distension, nausea, vomiting and constipation for last 48 hours. On examination, patient is dehydrated with PR = $110/min$ and BP = $100/60$ mm Hg. There is genera- lised tenderness, rebound tenderness present and board like rigidity on per- abdomen examination. The most likely complication of enteric fever in this patient is
