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Intussusception

Afiesimama BOA - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Intussusception

History: Patient is a 6 1/2 month old male that was brought to the Emergency Room via ambulance for an episode of apnea. He was found by his mother not breathing and unresponsive. She summoned help and a neighbor preformed rescue breathing and spontaneous respiration resumed before the ambulance arrived. The patient vomited several times while in transit. His mother states that he had been congested for approximately two weeks prior to the apneic episode but without cough. Past medical history is remarkable only for recent return from travel in the Phillipines and having received no immunizations. In the ER he was asymptomatic and was admitted to the ward for observation post life threatening event and to rule out seizure disorder or aspiration. He was place under respiratory isolation until Pertussis and RSV could be ruled out. On hospital day #2 he was noted to have decreased abdominal symptoms and to be passing dark guaiac positive stool. He slept poorly that night and was inconsolable. He was noted on hospital day #3 to have a distended abdomen.

Findings: Upright plain radiograph of the chest and abdomen shows paucity of bowel gas in the right abdomen and no free intraperitoneal air. Contrast enema demonstrates a filling defect in the hepatic flexure of the colon.

Ddx: Intussusception Neoplasm, such as lymphoma, much less likely in this age group.

Dxhow: Barium Enema

Exam: Physical exam was significant for increased bowel sounds, irritability on palpation of the right abdomen with a questionable small mass in the RUQ and mild guarding.

No MeSH data available.


AUpright chest and abdomen radiographs shows prominent mediastinal structures due to expiratory phase of respiration. There is no evidence of free air in the abdomen. There is paucity of bowel gas in the right abdomen.
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MPX2226_synpic38147: AUpright chest and abdomen radiographs shows prominent mediastinal structures due to expiratory phase of respiration. There is no evidence of free air in the abdomen. There is paucity of bowel gas in the right abdomen.


Intussusception

Afiesimama BOA - MedPix (2007)

AUpright chest and abdomen radiographs shows prominent mediastinal structures due to expiratory phase of respiration. There is no evidence of free air in the abdomen. There is paucity of bowel gas in the right abdomen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2226&req=5

MPX2226_synpic38147: AUpright chest and abdomen radiographs shows prominent mediastinal structures due to expiratory phase of respiration. There is no evidence of free air in the abdomen. There is paucity of bowel gas in the right abdomen.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Intussusception

History: Patient is a 6 1/2 month old male that was brought to the Emergency Room via ambulance for an episode of apnea. He was found by his mother not breathing and unresponsive. She summoned help and a neighbor preformed rescue breathing and spontaneous respiration resumed before the ambulance arrived. The patient vomited several times while in transit. His mother states that he had been congested for approximately two weeks prior to the apneic episode but without cough. Past medical history is remarkable only for recent return from travel in the Phillipines and having received no immunizations. In the ER he was asymptomatic and was admitted to the ward for observation post life threatening event and to rule out seizure disorder or aspiration. He was place under respiratory isolation until Pertussis and RSV could be ruled out. On hospital day #2 he was noted to have decreased abdominal symptoms and to be passing dark guaiac positive stool. He slept poorly that night and was inconsolable. He was noted on hospital day #3 to have a distended abdomen.

Findings: Upright plain radiograph of the chest and abdomen shows paucity of bowel gas in the right abdomen and no free intraperitoneal air. Contrast enema demonstrates a filling defect in the hepatic flexure of the colon.

Ddx: Intussusception Neoplasm, such as lymphoma, much less likely in this age group.

Dxhow: Barium Enema

Exam: Physical exam was significant for increased bowel sounds, irritability on palpation of the right abdomen with a questionable small mass in the RUQ and mild guarding.

No MeSH data available.