Presentation
The patient was brought to the emergency department by the parents, presenting with a one-day history of abdominal pain, vomiting, and passage of bloody stool. On examination, a palpable sausage-shaped mass was identified on the right side of the umbilicus. The mass exhibited characteristics of being smooth, firm, and mobile, with no discernible movement with respiration.
Patient Data
A roughly 7 x 3 cm mass of intussuscepted bowel is observed within the right upper quadrant, characterized by the presence of echogenic fat, mesenteric lymph nodes ("pseudokidney sign"), and a small quantity of fluid encapsulated within its center, all without apparent vascular compromise.
Case Discussion
The patient presented with a one-day history of abdominal pain, vomiting, and bloody stool, prompting concern for this gastrointestinal emergency. Upon examination, a palpable mass was identified in the abdominal region, consistent with the characteristic presentation of intussusception. Diagnostic imaging, typically ultrasound, confirmed the diagnosis by revealing specific features indicative of this condition.
Prompt recognition and intervention are crucial in managing intussusception to prevent potential complications such as bowel necrosis and perforation. Non-operative reduction techniques, such as pneumatic or hydrostatic methods, are often attempted initially to resolve the intussusception. However, surgical intervention may be required in cases of unsuccessful reduction or signs of bowel compromise.
This case underscores the importance of maintaining a high index of suspicion for intussusception in infants presenting with symptoms of abdominal pain, vomiting, and bloody stool. Early diagnosis and appropriate management significantly improve patient outcomes and reduce the risk of complications associated with this condition.
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