First one with correct answer with justification win.

 

[size=20px]You are called by the emergency department to consult on a ten-day old full term male infant with bilious vomiting. The baby is hemodynamically stable and the abdominal exam is unremarkable. An abdominal ultrasound obtained by the emergency physician suggests that the superior mesenteric artery lies to the right of the vein and that there might be “swirl sign”. Your plan in this patient with bilious vomiting should be immediate

 

A repeat the ultrasound with graded compression

 

B upper gastrointestinal series.

 

C contrast enema.

 

D computerized tomography of the abdomen.

 

E laparotomy.[/size]

B

B

correct

 

as long as the child is hemodynamically stable & abdomen not surgical, upper gastrointestinal study should be done. if child is shocked/septic surgical exploration should not be delayed waiting for imaging.

Any video link describing open Ladd's procedure

Thank you for your comment,

it will be added soon

(Untitled)

 

then what was the indication of doing the US? if tiu dont trust the US(

which is acceptable) then why dont you do the contrast from the start?

In some centers, there is increasing use of US to diagnosis malrotation by detection of reversal of relation between SMA and SMV, and results compared with UGI study are promising, yet evidence is still low to recommend US as standard of care

14 day old baby with bilious vomiting. Abdominal Sonography