Q- An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today, and his stool was like red jelly. He vomited all the food and water. He is also weak, fussy, and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis.
What is the next step of management for this patient?
A- MRI of the abdomen
B- Colonoscopy
C- IV hydration and antibiotics
D- Contrast enema
E- Refer to surgery for bowel resection
Answer and Explanation
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The presentation is classic for intussusception:
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“Red jelly” stool (currant jelly)
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Intermittent abdominal pain, vomiting
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Palpable abdominal mass (sausage-shaped)
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Empty right lower quadrant (Dance sign)
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Ultrasound confirms the diagnosis.
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The next step in management (if no perforation, shock, or peritonitis) is a contrast enema (air or barium), which is both diagnostic and therapeutic by reducing the intussusception.
Why the other options are wrong:
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A — MRI: Not needed; ultrasound is sufficient.
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B — Colonoscopy: No role in acute pediatric intussusception.
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C — IV hydration and antibiotics: Supportive only; does not treat the cause.
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E — Surgery: Reserved for failed enema reduction or complications (perforation, peritonitis).
The correct answer is D
Key takeaway:
👉 Stable infant with confirmed intussusception → contrast (air) enema is first-line treatment.
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