Paediatric Surgery

Causes of Constipation in childhood

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Q) A 4-year-old child presents with a history of infrequent, hard stools associated with painful defecation. There is no history of vomiting, fever, or blood in the stool. On examination, there is a palpable fecal mass in the left lower abdomen, and the anal tone is normal. What is the most likely diagnosis? # Theme from Mock test 32

A) Hirschsprung disease
B) Functional constipation
C) Intussusception
D) Anal fissure

Ans b

Functional constipation is the most common cause of constipation in children. It is characterized by hard stools, infrequent bowel movements, and often associated with painful defecation leading to stool withholding.

It is diagnosed clinically based on the Rome IV criteria, with no evidence of an organic cause.

Why the other options are incorrect:

A) Hirschsprung disease:

  • Typically presents in infancy with failure to pass meconium within 48 hours, abdominal distension, and bilious vomiting. The anal tone may be increased, and rectal examination may reveal an explosive release of stool.

C) Intussusception:

  • Presents with intermittent, severe abdominal pain, vomiting, and "currant jelly stools." A palpable "sausage-shaped" mass is found in the abdomen, not a fecal mass.

D) Anal fissure:

  • Can cause painful defecation, but it is usually associated with streaks of bright red blood on the stool and pain during defecation, without palpable fecal masses.

TEF

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Q) which of the following statement is false with respect to most common type of TEF(tracheoesophageal fistula)?
A) type C with female predominance
B )proximal blind pouch ends one or two vertebral bodies from distal TEF
C) distal TEF is located 1cm above Carina
D) polhydraminos is often with isolated proximal atresia.

 

Clinical Paediatric surgery Question

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Q.  A 6 months old baby is brought to the emergency with continuous crying and drawing his legs up for 1 day. He has vomiting and passage of bloody stools. On examination a lump is found in right hypochondrium. What is the best clinical diagnoses?

Choices and Answer for Premium 

 

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