Treatment

Surgical intervention will almost always be necessary if an anatomical/mechanical defect of the Gl tract is present. Intestinal obstruction puts a patient at risk for perforation, which further deteriorates a patient's condition. A nasogastric tube is recommended in cases where obstruction has set in and the patient is ill. Careful monitoring of the patient's fluid status is required because of the likelihood of third spacing into ischemic bowel and decreased oral intake.

Comprehension Questions

131.1-3I.6| Match the following etiologies to the clinical vignette:

A. Malrotation with intermittent volvulus

B. Intussusception

C. Insecticide ingestion

D. Esophageal foreign body

E. Pyloric stenosis

F. Volvulus

[31.11 A 6-year-old boy left alone for 10 hours, now with hematemesis and pneumomediastinum on chest x-ray.

[31.21 A 3-week-old male infant with 2 days of projectile, nonbilious vomiting and constant feeding.

[31.3] A 7-year-old male with three episodes of severe abdominal pain and vomiting in the last month, previously diagnosed with failure to thrive.

[31.4] An 8-month-old female infant with bilious vomiting, constant abdominal pain for 12 hours, and upper GI study showing beaklike appearance of contrast.

[31.5] An 1 l-month-old male with intermittent bouts of crying and nonbilious vomiting, has a history of Meckel diverticulum. A small, elongated mass is felt on right side of his abdomen.

[31.6] A 4-year-old female with profuse vomiting, sweating, lacrimation. and diarrhea, who seizes in the emergency room.

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