Ileus, Adhesions, Intussusception, and Closed-Loop Obstructions

Question 1

MCC of intestinal obstruction between 5 months and 3 years of age

Answer 1

Intussusception

Question 2

MC abdominal emergency in children younger than 2yo

Answer 2

Intussusception

Question 3

Many ___ and few ___ intussusceptions reduce spontaneously

Answer 3

Small bowel-small bowel; small bowel-colonic

Question 4

Intussusception in infants 1 yr old or younger has been associated with ___ vaccine

Answer 4

Tetravalent rhesus-human reassortment rotavirus vaccine

Question 5

T/F Recognizable lead points for intussusception are found in majority of affected patients

Answer 5

F, only 2-8%

Question 6

Intussusception lead points are more common in what age group

Answer 6

> 2y/o and adults (90%)

Question 7

Post operative intussusception is what type

Answer 7

Ileoileal

Question 8

Type of intussusception associated with HSP

Answer 8

Ileal-ileal

Question 9

MC type of intussusception

Answer 9

Ileocolic

Question 10

T/F Most intussusceptions do not strangulate the bowel within the first 24 hours

Answer 10

True

Question 11

Lethargy disproportionate to abdominal signs

Answer 11

Intussusception

Question 12

Currant jelly stool is passed in 60% of patients with what condition

Answer 12

Intussusception

Question 13

Classic triad of intussusception

Answer 13

1) Palpable sausage-shaped mass
2) Bloody or currant jelly stool
3) Pain

Question 14

Combination of these 3 signs has a positive predictive value of >90% for intussusception

Answer 14

1) Paroxysmal pain
2) Vomiting
3) Palpable mass

Question 15

MC location of sausage-shaped mass in intussusception

Answer 15

RUQ

Question 16

Configuration of long axis of sausage-shaped mass of intussusception if it is in the RUQ

Answer 16

Cephalocaudal

Question 17

Configuration of long axis of sausage-shaped mass of intussusception if it is in the epigastrium

Answer 17

Transverse

Question 18

T/F Ileoileal intussusception in children less than 2 y/o presents chiefly with signs of small intestinal obstruction and resolves without treatment

Answer 18

True

Question 19

T/F Recurrent intussusception is seen more commonly after hydrostatic than surgical reduction

Answer 19

True

Question 20

Appearance of intussuception on USG

Answer 20

Tubular mass in the longitudinal view and

Doughnut or target appearance in the transverse view

Question 21

Ultrasound has a sensitivity and specificity of __ and ___ for intussusception

Answer 21

98-100, 98

Question 22

Positive test for intussusception by contrast enema

Answer 22

Filling defect or cupping in the head of the contrast media, or coiled-spring sign

Question 23

Hydrostatic vs air reduction for intus: Fewer complications and lower radiation exposure

Answer 23

Air reduction

Question 24

An ileoileal intussusception is best demonstrated by

Answer 24

USG

Question 25

T/F Untreated intus in infants is usually fatal

Answer 25

True

Question 26

Most infants with intussusception recover if it is reduced within

Answer 26

First 24 hrs

Question 27

Recurrence rate of intussusception after reduction

Answer 27

10%

Question 28

Recurrence rate of intussusception after surgical reduction

Answer 28

2-5%

Question 29

Most recurrences of intussusception occur within ___ of reduction

Answer 29

72 hrs

Question 30

Drug that may reduce frequency of recurrent intussusception

Answer 30

Corticosteroids

Question 31

Repeated reducible episodes of intus caused by lymphonodular hyperplasia may respond to

Answer 31

Treatment of identifiable food allergies if present