Ileus, Adhesions, Intussusception, and Closed-Loop Obstructions Flashcards
MCC of intestinal obstruction between 5 months and 3 years of age
Intussusception
MC abdominal emergency in children younger than 2yo
Intussusception
Many ___ and few ___ intussusceptions reduce spontaneously
Small bowel-small bowel; small bowel-colonic
Intussusception in infants 1 yr old or younger has been associated with ___ vaccine
Tetravalent rhesus-human reassortment rotavirus vaccine
T/F Recognizable lead points for intussusception are found in majority of affected patients
F, only 2-8%
Intussusception lead points are more common in what age group
> 2y/o and adults (90%)
Post operative intussusception is what type
Ileoileal
Type of intussusception associated with HSP
Ileal-ileal
MC type of intussusception
Ileocolic
T/F Most intussusceptions do not strangulate the bowel within the first 24 hours
True
Lethargy disproportionate to abdominal signs
Intussusception
Currant jelly stool is passed in 60% of patients with what condition
Intussusception
Classic triad of intussusception
1) Palpable sausage-shaped mass
2) Bloody or currant jelly stool
3) Pain
Combination of these 3 signs has a positive predictive value of >90% for intussusception
1) Paroxysmal pain
2) Vomiting
3) Palpable mass
MC location of sausage-shaped mass in intussusception
RUQ
Configuration of long axis of sausage-shaped mass of intussusception if it is in the RUQ
Cephalocaudal
Configuration of long axis of sausage-shaped mass of intussusception if it is in the epigastrium
Transverse
T/F Ileoileal intussusception in children less than 2 y/o presents chiefly with signs of small intestinal obstruction and resolves without treatment
True
T/F Recurrent intussusception is seen more commonly after hydrostatic than surgical reduction
True
Appearance of intussuception on USG
Tubular mass in the longitudinal view and
Doughnut or target appearance in the transverse view
Ultrasound has a sensitivity and specificity of __ and ___ for intussusception
98-100, 98
Positive test for intussusception by contrast enema
Filling defect or cupping in the head of the contrast media, or coiled-spring sign
Hydrostatic vs air reduction for intus: Fewer complications and lower radiation exposure
Air reduction
An ileoileal intussusception is best demonstrated by
USG
T/F Untreated intus in infants is usually fatal
True
Most infants with intussusception recover if it is reduced within
First 24 hrs
Recurrence rate of intussusception after reduction
10%
Recurrence rate of intussusception after surgical reduction
2-5%
Most recurrences of intussusception occur within ___ of reduction
72 hrs
Drug that may reduce frequency of recurrent intussusception
Corticosteroids
Repeated reducible episodes of intus caused by lymphonodular hyperplasia may respond to
Treatment of identifiable food allergies if present
