PAEDIATRICS
BOWEL OBSTRUCTION/INTUSSUSCEPTION
PromptCommon causes for bowel obstruction in children under 5
ResponseIn order:
Intussusception (commonest)
Incarcerated inguinal hernia (note other abominable wall hernias rarely cause bowel obstruction in kids)
Malrotation with midgut volvulus
Postoperative adhesions
Annular pancreas
Mesocolic hernia
Intussusception (commonest)
Incarcerated inguinal hernia (note other abominable wall hernias rarely cause bowel obstruction in kids)
Malrotation with midgut volvulus
Postoperative adhesions
Annular pancreas
Mesocolic hernia
Prompt
ResponseDouble bubble sign - High level bowel obstruction (Duodenal atresia)
Duodenal atresia is a congenital condition where the duodenum is narrowed or blocked. It can cause bilious or non bilious vomiting within the first 24 to 38 hours of neonatal life, typically following the first oral feeding. It is associated with in-utero polyhydramnios and is one of the most common causes of fetal bowel obstruction
Note Q states dx is duodenal atresia but also that infant is 6 weeks old… Not really compatible
This link is same XR - states duodenal atresia
https://radiopaedia.org/cases/duodenal-atresia-6
https://www.wikidoc.org/index.php/Duodenal_atresia_x_ray
Duodenal atresia is a congenital condition where the duodenum is narrowed or blocked. It can cause bilious or non bilious vomiting within the first 24 to 38 hours of neonatal life, typically following the first oral feeding. It is associated with in-utero polyhydramnios and is one of the most common causes of fetal bowel obstruction
Note Q states dx is duodenal atresia but also that infant is 6 weeks old… Not really compatible
This link is same XR - states duodenal atresia
https://radiopaedia.org/cases/duodenal-atresia-6
https://www.wikidoc.org/index.php/Duodenal_atresia_x_ray
Prompt
ResponseSoft tissue mass - Shadow in upper abdomen
Paucity of gas centrally and overall - Two large focally dilated loops of small bowel
Crescent sign with soft tissue mass projecting into dilated loop of bowel
Crescent sign = pathognomonic of intussusception - google images below to clarify
Paucity of gas centrally and overall - Two large focally dilated loops of small bowel
Crescent sign with soft tissue mass projecting into dilated loop of bowel
Crescent sign = pathognomonic of intussusception - google images below to clarify
PromptClassic triad of intussusception
ResponseColicky abdominal pain
Palpable mass
Current jelly stools
Palpable mass
Current jelly stools
PromptIntussusception clinical findings
ResponseRUQ mass
Abdo pain - episodic followed by profound lethargy and pallor
Vomiting
+/- rectal blood
US - target sign
Abdo pain - episodic followed by profound lethargy and pallor
Vomiting
+/- rectal blood
US - target sign
PromptDefinitive management of intussusception
ResponseAir enema (radiologic)
Surgical
Surgical
PromptComplications of intussusception
ResponseBowel ischaemia/necrosis
Bowel perforation with peritonitis
Vomiting with aspiration
Shock with cardiovascular collapse
Bowel perforation with peritonitis
Vomiting with aspiration
Shock with cardiovascular collapse