TYK273

Which of the following is NOT a surgical emergency?

a) Midgut volvulus with severe abdominal pain

b) Intestinal perforation with septic shock

c) Inguinal hernia with abdominal pain

d) Intussusception, with symptoms resolved

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Answer

Answer d. Intussusception may lead to ischemic bowel, but in many cases it may be reduced either spontaneously or via fluoroscopic-guided double-contrast enema (insufflation with rectal air and contrast). In most patients, there is no recurrence and surgery is not necessary. On the other hand, symptomatic/incarcerated inguinal hernia, midgut volvulus with risk of bowel infarction, and intestinal perforation are all surgical emergencies. Note that septic shock is NOT a contraindication to proceeding with this case, as the patient will likely not medically improve until source control (in the abdomen) has been achieved.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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