Page 1 of 2: guide questionosis for examinees- pediatric/abd-mass

doctorkarim · Credits: 80001 My Scrapbook

A 12 months old boy presents to the emergency department with a 6 hour history of vomiting, colicky abdominal pain, and irritability. On physical examination a sausage like mass is palpable in the right upper quadrant of the abdomen

What is the most appropriate next step in management?

A' Order a CT scan of the abdomen
B. Order a barium swallow
C. Obtain a surgical consultation
D. Follow up examination after 4 hours

iffat7865 · Credits: 843 My Scrapbook

I think diagnosis is intussusception and for this we do DRE,U\S and barium or water soluble contrast enema.

the intussusception is usually treated with either a barium or water-soluble contrast enema or an air-contrast enema, which both confirms the diagnosis of intussusception,

iffat7865 · Credits: 843 My Scrapbook

I this particular options I'll go with,

C. Obtain a surgical consultation

OBAMA · Credits: 1833 My Scrapbook

IT IS A CASE OF INTUSSUSEPTION,THE MOST COMMON ABDOMINAL EMERGENCY TO AFFECT CHILDREN MOSTLY UNDER 2 YRS OF AGE,IT IS MOST COMMON CAUSE OF INTESTINAL Obs FROM 3M_6YRS OF AGE.
AS IN THIS CASE I WOULD PREFER OPTION C.

doctorkarim · Credits: 80001 My Scrapbook

A' Order a CT scan of the abdomen

standard answer.
first confirm intusseption by CT scan then surgery

met5 · Credits: 2651 My Scrapbook

Actually, the barium enema is both therapeutic AND diagnostic. I don't see why you would need to confirm with a CT if you can already confirm and treat with enema. C is answer

million_dollar · Credits: 532 My Scrapbook

barium enema is both diagnostic and threputic , so i go with met5........it is c

doctorkarim · Credits: 80001 My Scrapbook

I did not see any choice in this question mention barium enema so why you said barium enema if there is not given in this question dear.

iffat7865 · Credits: 843 My Scrapbook

So diagnosis is still not known and its not intsussception.so we go for CT to find out the cause of abd pain(my understanding if answer is definite CT).

But iam still thinking its itussusception and ans should be diagnostic and therapeutic enema if this option is not given then next will be surgery)

sairababy · Credits: 1682 My Scrapbook

Dr K why you think that ans. is CT scan we have social medicine . what about cost effective screen that is the reason I will go for Barium enema since it was not given I will go for CT.

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