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Surgery Small & Large Intestine 75def45b

Red current jelly stool is feature of:

A
Intussuseption
B
Volvulus
C
Hirschsprung disease
D
CHPS
High-Yield Explanation
Ans. a (Intussusception). (Ref. Bailey and Love, 25th/pg. 79)IntussusceptionDefinitionOne portion of gut becomes invaginated within an immediately adjacent segment; invariably proximal into distal bowel.It Is composed of:1. Intussusceptum--entering or inner tube.2. Returning or middle tube3. Intussuscepiens--Sheath or outer tube.4. Leading point-- Hypertrophied payer's patch is most commonTypeIleocolic is most common type.Clinical featuresIntussusception should be considered in any infant with bloody stools and Red current jelly stool is characteristic of it, as is sign of dance or empty right iliac fossa on clinical examination.InvestigationsUSG and Barium enema are confirmatory. USG should be the first choice as it is free of ionizing radiation and can guide in hydrostatic reduction. Barium enema shows presence of iliocolic or colocolic form as 'claw' sign i.e. Ba in intussuception is seen as a claw around the negative shadow intussusceptum.Other radiological sign on BA enema is "Coiled-spring" sign. A Ba enema involves effective radiation dose of about 7 mvs.RxMost intussusceptions can be reduced non-operatively using an air or barium enema. Hydrostatic reduction is contraindicated in presence of obstruction, peritonism or prolonged history and is unlikely to be successful if a lead point is likely.

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