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Congenital Hydronephrosis Due to Pyeloureteral Atresia: A Case Report
Zainab H Alowainati1, Zainab H Salman2, Hibah A Alhamad3
1College of Medicine, Jordan University of Science and Technology, Irbid, JOR.
Insights
Infantile intussusception can present atypically. Early ultrasound is crucial for diagnosing this bowel obstruction, even without classic symptoms, ensuring prompt treatment and better outcomes.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
Background:
- Intussusception is a primary cause of infant intestinal obstruction.
- Classic symptoms include pain, vomiting, and currant jelly stools.
- Atypical presentations risk diagnostic delays and complications.
Observation:
- A seven-month-old infant presented with lethargy and irritability, lacking typical gastrointestinal signs.
- Initial clinical and laboratory assessments were inconclusive.
- Abdominal ultrasonography revealed a subtle 'target sign' indicative of intussusception.
Findings:
- The case confirmed intussusception in an infant with an atypical presentation.
- Successful hydrostatic reduction was performed under fluoroscopic guidance.
- No pathological lead points were identified.
Implications:
- Highlights the necessity of considering intussusception in infants with non-specific symptoms.
- Emphasizes the critical role of early ultrasonography in diagnosis.
- Underscores the importance of post-reduction monitoring and parental education for recurrence.
Abstract:
Intussusception is a leading cause of acute intestinal obstruction in infants, typically presenting with a classic triad of intermittent abdominal pain, vomiting, and currant jelly stools. However, atypical presentations can lead to diagnostic delays, increasing the risk of complications. This report describes a seven-month-old male with an unusual presentation of lethargy and irritability, without overt gastrointestinal symptoms. Initial clinical examination, including abdominal palpation and laboratory tests, was inconclusive. However, abdominal ultrasonography revealed a subtle "target sign," confirming intussusception despite the absence of hallmark signs. The patient underwent successful hydrostatic reduction under fluoroscopic guidance, with no pathological lead points identified. The case highlights the importance of maintaining clinical suspicion for intussusception in atypical presentations, emphasizing the critical role of early imaging in achieving timely diagnosis and favorable outcomes. Additionally, it underscores the need for vigilant post-reduction monitoring and parental education regarding recurrence.
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