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Challenger welcomes the faculty, residents, and
administration of
eResidency.com to our Quick Quiz Newsletter!
Issue: September 15, 2006
Case: Abdominal Pain
Taken from
Med-Challenger EM Career
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Question:
The barium enema (BE) can exclude appendicitis in
equivocal cases (by demonstrating normal filling of the
appendix). A cause of abdominal pain that usually occurs in 8-
to 18-month-old infants (but can occur in older children and
adults) for which BE or, preferably, air contrast enema, is both
the diagnostic and therapeutic procedure of choice, is __.
Answer Options:
- Meckel's diverticulum
- intussusception
- Hirschsprung's disease
- cecal volvulus
Answer:
B
Remediation:
The barium enema
may sometimes give a false negative result in the presence of
appendicitis when there is a distal obstruction of a long
appendix. In such cases, filling of the proximal appendix by
contrast may simulate a normal unobstructed appendix.
About the Image(s):
Image 1:
Intussusception - Abdominal
X-Ray
This patient had crampy abdominal pain and currant-jelly stools.
Intestinal obstruction is apparent on this plain x-ray. Barium
enema showed colonic intussusception with the barium column
stopping at a mass caused by the intussuscepted colon.
Image 2: Intussusception - Barium Enema
Barium enema in a patient with crampy abdominal pain and
currant-jelly stools. Colonic intussusception is noted, with the
barium column stopping at a mass caused by the intussuscepted
colon.
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