Question

A 18 month old female is brought to the physician by her mother, who is concerned that her child is in pain. The child has had spells of intense sceaming and crying for the past few hours; during these episodes the child doubles over and curls up into a ball. The mother also reports two episodes of non-bilious, non-bloody vomit. The mother initially thought that the patient may have caught a virus at day care, but she became more concerned one hour ago when her daughter had a bowel movement and the stool seemed to be slimy with a purplish color. On physical exam, a sausage shaped abdominal mass is palpated in the right abdomen. There is no abdominal rigidity, guarding, or rebound tenderness. An abdominal ultrasound reveals a ""bull's eye"" or ""coiled spring"" appearing lesion. The patient is made n.p.o., i.v. fluids are started, and a nasogastric suction is begun. What is the next best step in the management of this patient?

A. CT scan
B. Air contrast enema
C. Surgery
D. Colonoscopy
E. Administer a glycerin suppository

Answer 1

The next best step in the management of this patient is surgery. The patient's symptoms are suggestive of intussusception, and surgical intervention is the preferred treatment.

Option C.

Step-by-step explanation:

The next best step in the management of this patient is C. Surgery.

The patient's symptoms, such as intense screaming and crying, abdominal mass, and the presence of a purplish-colored slimy stool, are suggestive of intussusception.

Intussusception occurs when one part of the intestine slides into another part, causing a blockage.

Surgical intervention, specifically an air enema or resection of the affected segment, is the preferred treatment for intussusception in infants.