An 18-year-old boy presents with intermittent severe central colicky abdominal pain and red currant jelly stool. Ultrasound suggests intussusception. Which statement about his management is correct?
- A Air enema reduction is the definitive treatment
- B Hydrostatic enema reduction followed by observation
- C Surgical exploration with resection without attempted preoperative reduction ✓
- D Antiparasitic therapy followed by elective imaging
Correct answer: C. Surgical exploration with resection without attempted preoperative reduction
Explanation
Intussusception in adults and older adolescents is nearly always secondary to a pathological lead point, commonly a benign or malignant neoplasm such as a lipoma, polyp, or lymphoma. Because manipulation risks dissemination of malignant cells and reduction does not address the lead point, standard management is segmental resection with the mass en bloc, followed by appropriate oncological staging. Non-operative enema reduction is the accepted approach only in idiopathic childhood intussusception.
Reference: Schwartz's Principles of Surgery, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.