Intussusception — DCH MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCommon childhood illnessesIntussusceptionDCH

A 9-month-old infant has intermittent episodes of screaming and drawing up his legs. Between episodes he appears pale and tired. Examination shows a soft abdomen with a sausage-shaped mass in the right upper quadrant. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Intussusception

The diagnosis is intussusception. The combination of an infant in the typical age range, sudden recurrent colicky pain with the legs drawn up, pallor or lethargy between episodes, and a right-sided sausage-shaped abdominal mass is characteristic. Blood and mucus producing a redcurrant-jelly stool is a late sign and is not required for diagnosis. Infantile colic usually occurs in younger infants and does not cause pallor, lethargy or an abdominal mass. Pyloric stenosis typically presents earlier with progressive non-bilious projectile vomiting rather than episodic pain. Appendicitis more often causes persistent pain and focal tenderness, while constipation would require a supportive stool history and does not explain the episodic pallor.

Reference: Sheffield Children's NHS Foundation Trust. Emergency Department Medical Guidelines: Neonatal surgical problems, section C: Intussusception. Implemented August 2024; review August 2027. https://www.sheffieldchildrens.nhs.uk/download/1722/surgical-problems/64233/5-1-neonatal-surgical-problems.pdf