Question

an infant who is being weaned is crying incessantly and is also vomiting. questioning of the mother reveals that it is passing
ed currant jelly\ stools. on palpation a sausage - shaped mass may be felt in the right iliac fossa. which of the following conditions is the most likely diagnosis in this infant? congenital pyloric stenosis intussusception hirschsprung disease meconium ileum meckels diverticulum

Explanation:

• Congenital pyloric stenosis: Presents with projectile vomiting, a palpable olive - shaped mass in the epigastrium, and no "red currant jelly" stools. So this is not the correct diagnosis.
• Intussusception: Common in weaned infants. Clinical features include inconsolable crying, vomiting, "red currant jelly" stools (due to intestinal ischemia and bleeding), and a sausage - shaped mass (the intussusceptum) that can be felt in the right iliac fossa. This matches the given symptoms.
• Hirschsprung disease: Characterized by chronic constipation, abdominal distension, and failure to pass meconium in the neonatal period. There are no "red currant jelly" stools or a sausage - shaped mass as described.
• Meconium ileum: Occurs in neonates, presents with abdominal distension and failure to pass meconium, with meconium - filled loops of bowel. It does not have the features of the given case.
• Meckel's diverticulum: May present with painless rectal bleeding in children, not the combination of symptoms described here.

Answer:

Intussusception