A previously healthy infant presents with recurrent episode of abdominal pain. The mother says that the child has been passing altered stool after episodes of pain, but gives no history of vomiting or bleeding per rectum. Which of the following is the most likely diagnosis -

Ans is 'b' i.e., Intussuception o The infant in question has: (i) Recurrent episodes of abdominal pain (ii) Passing of altered stools after episodes of pain (iii) No vomiting or bleeding per rectum. o Most common presentation of rectal polyps and Meckel's diveiculum is painless rectal bleeding (option a & c are ruled out) o Necrotizing enterocolitis is seen in premature infants and is manifested in neonatal period. Symptoms progress from abdominal distension, vomiting, lethargy, poor feeding to passage of grossly bloody stool and features of shock (option d is excluded) o Now we are left with intussusception. Most common presentation is recurrent abdominal pain (Paroxysmal clocky pain ofter severe). o The absence of history of bleeding per rectum is creating some confusion here. o However, altered stool should raise the suspician of intussuception because intussuception typically present with "current jelly stool" (altered stool) representing a mixture of blood, mucus and stool. o So, amongst the given options, best answer is intussusception.