WBR0591

Author	[[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pathology
Sub Category	SubCategory::Gastrointestinal
Prompt	[[Prompt::A 2 year old male patient is brought by his mother to the emergency department (ED) because he has new-onset nonbilious vomiting, colicky severe abdominal pain, and blood per rectum and stools that resemble currant jelly. His past medical history is remarkable only for a recent upper respiratory tract infection with adenovirus. He was born by an uneventful normal vaginal delivery. On physical examination, a mass is palpated on the right side of the abdomen. Which of the following best describes the patient's condition?]]
Answer A	AnswerA::Circumferential infolding of the rectal mucosa
Answer A Explanation	AnswerAExp::Intussusception is defined as the circumferential infolding of the rectal mucosa.
Answer B	AnswerB::Twisting of a portion of the bowel around its mesentery
Answer B Explanation	AnswerBExp::Volvolus is defined as the twisting of a portion of the bowel around its mesentery
Answer C	AnswerC::Lack of ganglion cells of the enteric nervous plexus
Answer C Explanation	AnswerCExp::Hirschsprung's disease is defined as lack of ganglion cells of the enteric nervous plexus.
Answer D	AnswerD::Blind pouch protruding from the alimentary tract
Answer D Explanation	AnswerDExp::Diverticulum is defined as blind pouch protruding from the alimentary tract
Answer E	AnswerE::Submucosal inflammation with friable pseudopolyps
Answer E Explanation	AnswerEExp::Ulcerative colitis is characterized by the presence of submucosal inflammation with friable pseudopolyps on biopsy.
Right Answer	RightAnswer::A
Explanation	[[Explanation::Intussusception is defined as the circumferential infolding of the rectal mucosa. It is not an uncommon disease of the pediatric population that is characterized by the triad of non-bilious vomiting that might become bilious in the case of complete obstruction, severe colicky abdominal pain, and currant jelly stools. Intussusception is shown to occur following an upper respiratory tract infection, commonly an adenovirus infection. However, the true association between the two is not well established. On physical examination, patients might have a palpable abdominal mass, commonly in the right side because intussusception is usually found at the ileocecal junction. Intussusception is considered an emergency. Air enema is considered diagnostic and therapeutic. Intussusception in the adult population usually prompts the investigation for a tumor that acts as a lead point for the infolding of the mucosa. Educational Objective: Intussusception is a pediatric disease that is defined as circumferential infolding of the rectal mucosa. Symptoms include the triad of vomiting, colicky abdominal pain, and currant jelly stools. Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::colicky, WBRKeyword::abdominal, WBRKeyword::pain, WBRKeyword::vomiting, WBRKeyword::nonbilious, WBRKeyword::non-bilious, WBRKeyword::bilious, WBRKeyword::currant, WBRKeyword::jelly, WBRKeyword::stools, WBRKeyword::blood, WBRKeyword::rectum, WBRKeyword::pediatric, WBRKeyword::rectal, WBRKeyword::mucosa, WBRKeyword::infolding, WBRKeyword::Intussusception
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