A process that occurs when a proximal segment of bowel 'telescopes' into a more distal segment, causing oedema, vascular compromise and ultimately, partial or total bowel obstruction is called?

Appeared in: DSSSB - 29 August 2019 (Shift-1)

Explanation

Intussusception is the medical term for a condition where one segment of the intestine slides or 'telescopes' into an adjacent segment.
This process is often driven by peristalsis, where the proximal part (the intussusceptum) invaginates into the distal part (the intussuscipiens).
The telescoping action drags the mesentery along with it, compressing blood vessels. This leads to venous congestion, edema (swelling), and ultimately blocks the bowel, causing the obstruction described in the question.
If left untreated, this vascular compromise can lead to ischemia, infarction, and perforation, making it a medical emergency.

Option B: Peptic ulcers are open sores that develop on the inner lining of the stomach and the upper portion of the small intestine. They are caused by erosion from stomach acid and are not related to the mechanical telescoping of the bowel.
Option C: Gastroesophageal reflux is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus. It is a problem with the lower esophageal sphincter, not a bowel obstruction.
Option D: Appendicitis is the inflammation of the appendix, a finger-shaped pouch that projects from the colon on the lower right side of the abdomen. It causes pain, fever, and nausea but does not involve the telescoping of the intestine.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Intussusception as background academic context rather than a clinical decision trigger.
Intussusception is the most common cause of intestinal obstruction in children between 3 months and 3 years of age and is considered a pediatric emergency.
Nurses must be able to recognize the classic triad of symptoms: sudden onset of severe, colicky abdominal pain; a palpable sausage-shaped abdominal mass; and the passage of 'currant jelly' stools.
Prompt recognition and reporting are critical, as non-surgical reduction using an air or hydrostatic enema is often successful if performed early. Delay can lead to bowel ischemia, perforation, and the need for surgical resection.

How to Approach the Question

First, read the question carefully and identify the key descriptive phrase: "a proximal segment of bowel 'telescopes' into a more distal segment."
Recognize that "telescoping" is a very specific and classic description for a particular medical condition.
Review the given options: Intussusceptions, Peptic ulcers, Gastroesophageal reflux, and Appendicitis.
Match the keyword "telescoping" to its correct medical definition among the options. Intussusception is the direct term for this process.
Mentally eliminate the other options by recalling their definitions. Peptic ulcers are sores, GERD is acid reflux, and appendicitis is inflammation. None of these involve the telescoping of the bowel, confirming your choice.

Concept Tested & Keywords

Concept Tested: Pathophysiology of Intussusception
Stem keywords: proximal segment, bowel, telescopes, distal segment, oedema, vascular compromise, bowel obstruction
Lead-in keywords: is called

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 782-784

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 3 (515-969) p. 45-47

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 81-83

Practise the full DSSSB - 29 August 2019 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.