Recurrent obstruction, mass per rectum and diarrhoea in child –
**Core Concept**
The question is testing the ability to diagnose a child with a condition characterized by recurrent obstruction, mass per rectum, and diarrhea, which is likely to be a case of intussusception. Intussusception occurs when a part of the intestine folds into the adjacent part, causing a blockage and potentially leading to ischemia and necrosis.
**Why the Correct Answer is Right**
Intussusception is a common condition in children, typically presenting with abdominal pain, vomiting, and bloody stools, followed by a palpable mass per rectum. The exact cause is often unclear, but it is thought to be related to an abnormality in the intestinal mucosa, which leads to a "lead point" for the intussusception to occur. The condition requires prompt medical attention to avoid complications such as bowel necrosis and perforation.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not accurately describe the clinical presentation of intussusception. The condition typically presents with abdominal pain, vomiting, and bloody stools, not just a palpable mass per rectum.
**Option B:** This option is incorrect because it is a condition that presents with abdominal pain and vomiting, but not typically with a palpable mass per rectum or diarrhea.
**Option C:** This option is incorrect because it is a condition that presents with abdominal pain and diarrhea, but not typically with a palpable mass per rectum.
**Clinical Pearl / High-Yield Fact**
The classic triad of intussusception is abdominal pain, vomiting, and bloody stools, but the presence of a palpable mass per rectum is a key diagnostic feature. A rectal examination should always be performed in children with suspected intussusception.
**Correct Answer:** H. Hirschsprung's disease is a condition characterized by a congenital absence of ganglion cells in the distal colon, leading to a functional obstruction.