Step 1

Gastrointestinal 2

A one-year-old boy presents with his father to the emergency department with bloody diarrhea, bilious vomiting, and irritability. The father states the symptoms developed yesterday and have persisted today. Past medical history is unremarkable. Vital signs are temperature 37.2°C (99°F), blood pressure 90/70 mm Hg, heart rate 165 beats/min, and respirations 22/minute. Physical examination reveals increased bowel sounds, a palpable mass in the abdomen, and tenderness to palpation in the lower right quadrant of the abdomen.

Which of the following is the most likely etiology of this patient's symptoms?

  • A) Congenital failure of the duodenum to canalize
  • B) Enlargement of the pyloric smooth muscle
  • C) Failure of involution of the vitelline duct
  • D) Failure of neural-crest cells to descend into the myenteric and submucosal plexus
  • E) Obstruction of the appendix secondary to lymphoid hyperplasia

Authors

Parker Korbitz

Editor

Dr. Ted O'Connell

Source

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