15yr old male who presented with a abdominal distension, vomiting and weight loss of 3months duration. Vomitus was bilious, projectile, aggravated by feeding. Examination findings revealed a chronically ill looking child, he was dehydrated, pale, anicteric, febrile, with mild bilateral pitting pedal edema. Abdomen was soft, full, moved with respiration with no areas of tenderness. Liver was enlarged 6cm below the subcostal margin, spleen and kidneys were not enlarged. Following several investigations and work up for surgery , this was seen by the surgeons on the operating table during an Ex-lap. What could have been their diagnosis from the brief history and clinical picture?

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THIS CASE PROBABLY LOOKS LIKE GROSSLY DISTENDED INTESTINAL LOOPS, WITH BLIND SEGMENTED BOWEL LOOPS IN THE PROXIMAL PORTION. WHILE THE DISTAL SEGMENTED BOWEL LOOPS ARE GANGRENEOUS, CONSISTENT WITH TUBERCULOUS ABDOMEN. DX : T.B. ABDOMEN WITH GANGRENE. D/D: VOLVULOUS. INTUSSCESPTION. { DUE TO MESENTERICLYMPHADENITIS}.

Ileo caecal knotting either due to congenital bands or mal rotation of gut

It is chronic Malrotation with midgut volvulus without gangrene. Had it been a gangrene or perforation, then abdomen couldn't be soft. History is long. Child is 15 years old. Vomiting is billious, projectile....surgical pic....going in favour of gut Malrotation.

Ileo caecal knotting l/t gangrene

Chronic intussusception with obstruction and gangrene with sepsis.

i perforation.peritonitis

Some form of small bowel obstruction@requiring iliostomy at the end.

1.Hypertrophic pyloric stenosis 2.SMA syndrome 3.Post duodenal ulcer stricture 4.Ladd's band

volvulus with gangrene. Exploration and resection is the treatment.

Ileoeacal obstruction but wht is the cause of liver enlargement

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