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Old 08-02-2012
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GIT Initial step in management of Intussuception!

In MTB 3 pg 359, under the topic of Intussusception there is a question given whose answer is reduction of the telescoped bowel....

In MTB 2 CK pg 426, under the treatment of intussception they have mentioned fluid resuscitation and balancing of electrolytes are the most important initial steps .....

So which of these should be the correct statement?
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In the context of the question....if its mentioned... patient is dehydrated and electrolytes are deranged...of course fluid resuscitation carries the day!!

But if patient not unduly toxic and you are asked most appropriate mgt then go for reduction of the telescoped bowel!!!
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Quote:
Originally Posted by stfidel View Post
In the context of the question....if its mentioned... patient is dehydrated and electrolytes are deranged...of course fluid resuscitation carries the day!!

But if patient not unduly toxic and you are asked most appropriate mgt then go for reduction of the telescoped bowel!!!
i think u didn't look for it in MTB 3...ques says child had diarrhorea for 1 week.......and they have answered reduction of bowel as correct next step....
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will check it up
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I'd agree with the poster above, if patient is unstable (hypotensive, tachy etc.) => Fluids

If pt is stable, then do the enema.

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Tailor treatment of the child with intussusception to the stage at presentation. For all children, start intravenous fluid resuscitation and nasogastric decompression as soon as possible.
The presence of peritonitis and any evidence of perforation revealed on plain radiographs are the only 2 absolute contraindications to an attempt at nonoperative reduction with a therapeutic enema.
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