Intestinal Obstruction

Question 1

Intussusception
Clinical features
Types
Radio findings
Treatment

Answer 1

C/F
1) Pain (drawing up legs and crying baby)
2) Abdominal distension
3) Vomiting
4) Red currant jelly stool (blood + mucus)
5) Sign of the dance (sausage shaped lump in the lumbar region with con cavity towards umbilicus and a feeling of emptiness in RIF)

Types- Primary & Secondary

Radio findings
1) IOC : CECT (adults) & USG (children)
2) CT - Target shaped or sausage shaped mass, mesentery c vessels within bowel loop
3) USG: Donut/Target sign, Pseudokidney sign
4) Barium enema: Claw or Pincer sign

Treatment
1) Contrast enema may be therapeutic
2) Reduction of intussusception
3) Surgery (Indications: recurrent cases, secondary lead point, strangulation, perforation)
- Resection and anastomosis

Question 2

Intestinal stricture cause & management

Answer 2

Causes: TB and Crohn’s disease

Management:
1) In TB, the strictures are closely spaced —> Heinke Miculicz stricturoplasty (make a longitudinal incision and suture it transversely)

2) In crohn’s, the strictures are far apart —> Finney stricturoplasty