A 10 month old infants presents with acute intestinal obstruction. Contrast enema X-ray shows the intussusceptions, likely cause is –
Intussusception in infants is a common cause of acute intestinal obstruction. The peak age is 6-24 months, so 10 months fits. The main causes are usually a lead point, like a Meckel's diverticulum, or it can be idiopathic. In older children, it's often idiopathic, but in younger ones, a lead point is more common. Meckel's diverticulum is a common lead point because it's a remnant of the vitelline duct. So the correct answer is likely Meckel's diverticulum.
Now, the options aren't given, but the user wants the explanation structured with core concepts, why correct is right, why others are wrong, clinical pearl, and correct answer line. Let me outline each section.
Core Concept: Intussusception in infants under 2 years is often due to a lead point like Meckel's diverticulum. The vitelline duct remnant can cause the telescoping.
Why Correct Answer is Right: Meckel's is a common lead point in this age group. The pathophysiology involves a portion of the intestine slipping into another, causing obstruction and potential ischemia.
Wrong Options: Other options might include things like Peyer's patches (common in older children), tumors (rare in infants), or volvulus (less common here). Each of these is incorrect because they don't fit the age group or typical causes.
Clinical Pearl: Remember that in infants under 2, Meckel's is a key cause. Classic triad is vomiting, blood in stool, and abdominal swelling. Contrast enema can both diagnose and sometimes reduce the intussusception.
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**Core Concept**
Intussusception in infants under 24 months is most commonly caused by a **lead point** such as **Meckel's diverticulum**, a remnant of the vitelline duct. This condition occurs when a segment of intestine telescopes into an adjacent segment, leading to obstruction and ischemia. The peak incidence aligns with the 10-month-old age group in the question.
**Why the Correct Answer is Right**
**Meckel's diverticulum** is the most frequent anatomic abnormality causing intussusception in young children. It acts as a focal point for peristalsis to pull the bowel into itself. Pathologically, it contains heterogeneous tissue (gastric or pancreatic), which can ulcerate and bleed, contributing to inflammation and telescoping. Contrast enema confirms the diagnosis and may reduce the intussusception by decompression.
**Why Each Wrong Option is Incorrect**
**Option A:** *Peyerβs patches* are a common lead point in older children (2β5 years) but not in infants.
**Option B