Page 2 of 2: guide questionosis for examinees- pediatric/abd-mass

doctorkarim · Credits: 79337 My Scrapbook

Dr. Sairababy
This question is to let you think when you are in a clinic, and there is no option in this question for barium enema so we know that is intussuption just from clinical and physical examintation but just we need to confirm the diagnosis.How to cinfirm according to the choices given is Ct scan because intussuption is ann emergency condition so fatest way t o confirm diagnosis of intussuption if no barium enema was given in the question as barium sawallow given here is not benifit to giagnose it so we need to confirm the giagnosis with fast method of CT scan then call for surgical consultation.
by the way the answer was taken from orginal reference who post the question so it is standard question trust me

adrian · Credits: 1979 My Scrapbook

As you are a"snow-drop" you should go for C).They will decide what's best to do....

usmleme · Credits: 178 My Scrapbook

there are certain indications for surgery like unsuccessful attempt at reduction so cant go straight to surgery at this time so in this scenario CT is the only diagnostic modality to go for.

Nesta_13 · Credits: 167 My Scrapbook

Hello everybody ,,

in the Q. there is 2 point
1) it mentioned that the child presented to ER witch you have to consider this point.
2) the Q was what is the next step ,, that means it's asking about the order of event not witch one is correct.

SO, i think the correct answer is Surgical consultation.

good luck

Vinnie90 · Credits: 183 My Scrapbook

it is C

eye_61 · Credits: 249 My Scrapbook

Of the choices given, the most appropriate answere is "C".
According to emedicine:
" Only perform a contrast enema in consultation with the surgeon caring for the child and the radiologist interpreting the study"

victorau · Credits: 115 My Scrapbook

It should be C -surgical consultation
Pediatric surgery should be involved as soon as possible in cases of intussusception in the ER. Barium enema was not given as a choice. Patient would probably vomit the barium swallow.

CT findings are unreliable for pediatric intussusception and carry risks with contrast, radiation, and sedation.

Patient is a little bit older too than typical 2-3yo patient with intussusception, so barium enema would be less successful therapeutically. Surgery is the most likely mode of therapy. please refer to emedicine.

mohdiraq · Credits: 1706 My Scrapbook

i go with surgical concutation
as CT scan willexpose the patient to radiation and cost ineffective in addition it is not sensative test for intusseption as from history goes with intussesptin

doctorkarim · Credits: 79337 My Scrapbook

In fact, this question was an old exam's question was done out side Canada . The answer was taken from the official office who post the question. so the standard answer was:
A' Order a CT scan of the abdomen
even if you consult the surgeon, will need to confirm the diagnosis and will go with CT if he had same question.

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