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Clinical VignetteA clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.
A 2-week old neonate presents with regurgation and persistant, severe projectle vomiting. An olive-like epigastric mass is felt during the physical examnation. A chest x-ray does not revel the presence of bowel gas in the chest cavity. This infant's mother did not have polyhydramnios during this pregnancy. What is the best treatment for this infant's condition?
a. Oral medication with omeprazol and clarithromycin.
b Oral medication with vancomycin or metronidazol.
c. Surgery to cut a hypertrophid stenotic band at the pylorus.
d. Surgery to remove a mass of adrenal gland.
e. Surgery to resect an aganglionic section of the intestine.
its c Surgery to cut a hypertrophid stenotic band at the pylorus.
i think so because olive like mass is found in the case of pyloric stenosis...........and projectile vomiting in 2 weeks child suggest congenital pyloric stenosis.......
"If patient recovers god saved him and if patient dies doctor killed him" is it fair?
Last edited by santoshkhanal; 29-06-2006 at 09:52 AM.
yep. correct answer is c
Severe congenital abnormalities of the gastrointestinal tract usually presents with specific symptoms. such as in this case of infant with congenital hypertrophic pyloric stenosis present in the 2nd or 3rd week of life with symptoms of regurgation and persistant severe vomiting.
In such cases on physical examination reveals a firm mass in the region of the pylorus. Surgical splitting of the muscle in the stenotic region is curative.
Re: Clinical MCQs -
29-06-2006, 08:29 AM
Linear Mode
