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Originally Posted by phenobarb The question above dosent provide with much information, 1. neonate otherwise normal starts vomiting at 10 days, nature and content of vomit would have been a great clue 2.any bowel movements?3.childs general state.4. additional lab results and imaging would have had a confirmatory diagnosis.
anyways thanks! |
phenobarb, I don't think the question is incomplete as GI obstruction in an otherwiese healthy infants with the feeding history is a great clue to the intusssusception. In more than 95% of cased, it is thought that a hypertrophied Peyer's patches may cause a loop of intestine to invaginate within the distal loop during the propagation of a peristaltic wave. The hyperthrophy in the Peyer's patches is thought to be due to change in the bacetrial flora that accompanies weaning from the breastfeed and introduction fo the other feeds, which is a feature in babies of less than 10 month of age group. I guess the feeding history is included in the history. And for other option explanation is there.
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Originally Posted by Hero Red currant jelly stool, and "signe de dance" would have confirm the diagnosis of intussusception. One text book has mentioned a very interesting feature of this disease: "bachha sota hai to rota hai" hehe...its really interesting. Child suddenly gets up and start crying due to spasm. |
As I said the GI obstruction in an otherwise healthy infant and the existing options point towards the intussusception.
Red currant Jelly Stool : As the intussusception advances the venous congestion withing the innermost layer of the intestine causes the sectreion of bloody mucus which is characteristically passed as stool traditionally known as Red curran jelly stool.
Signe de dance: In ileocecal intussusception which is the the common variety, almost from the beginning of the illness the right iliac fossa will appear empty on palpation due to the taking up of the cecum into the advancing invagination
Both of these Red currant Jelly Stool & Signe de dance definately help in the diagnosis but patient do not present with all the sign and symptoms we read. Existing information is enough to diagnose intussusception. These information would have helped in the diagnosis of the intussusception if the option weren't given.
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Originally Posted by bharat well there are diffrent kind of Intussusception just like
colic intussusception
double intussusception
ileal intussusception
ileocecal intussusception
ileocolic intussusception
jejunogastric intussusception
retrograde intussusception
what are diffrent feature in these cases pleae clear me bro. |
Yes, bharat there are variety of intussusception as you have mentioned it as the intussusception is limited to the childer below 10 month of age so the child will present with the abdominal pain only on clinical finidng there might be subtle variation but operative finding would be the most diagnostic of all, despite USG, CT and X-ray for intestinal obstruction. Unlike adult, childern do not express the symptoms.
All of them will present with vomiting, passage of blood in the stool and abnormal crying due to abdomina pain. The pain is colicky, and occurs in the short bursts of severe pain and draw the legs up towards the abdomen. As soon as the colic settles, the baby quietens down. The relief is temporary, since the attack repeats itself.
All those type can only be diagnose only when abdomen is cut opened to correct the intussusception. And the child will present with the same symptoms and signs of a typical intussusception.
Re: GI obstruction in a normal infant who begins feeding second day then at tenth day -
17-08-2006, 08:50 AM
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