______ is imagination or telescoping of portion of the intestine into an adjacent, more distal section of the intestine, which creates a mechanical obstruction?

Appeared in: ESIC Nursing Officer 2016 (shift-1)

Explanation

Intussusception is the medical term for the telescoping of one part of the intestine into an adjacent part.
This process, also called invagination, creates a mechanical obstruction that blocks the passage of intestinal contents.
The telescoping action can compromise blood supply to the affected bowel segment, leading to swelling, bleeding, and potential necrosis.
It is the most common cause of intestinal obstruction in children between 5 months and 3 years of age.
Classic signs include sudden, severe abdominal pain, a palpable sausage-shaped mass, and "currant jelly" stools (a mix of blood and mucus).

Option A: Hirschsprung's disease is a functional obstruction caused by a lack of nerve cells (aganglionosis) in the colon, which impairs peristalsis. It does not involve the mechanical telescoping of the intestine.
Option B: An aneurysm is a localized, blood-filled bulge in the wall of a blood vessel. It is a cardiovascular condition and has no relation to the intestines or mechanical obstruction.
Option C: Enterocolitis is the inflammation of the lining of the small intestine and colon. While it can cause abdominal pain and bloody stools, and can be a complication of other GI disorders, it is an inflammatory condition, not a mechanical telescoping obstruction.

Visual 1: Diagram: Illustration showing the telescoping of the ileum into the cecum, clearly labeling the 'intussusceptum' and 'intussuscipiens'.
Visual 2: Illustration: Depiction of the 'currant jelly' stool to help visualize this classic sign.
Visual 3: Ultrasound Image: A transverse view of an intussusception showing the characteristic 'target' or 'doughnut' sign.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Gastrointestinal Obstruction as background academic context rather than a clinical decision trigger.
Intussusception is a pediatric emergency. A nurse must be able to recognize the classic triad of symptoms (colicky pain, sausage-shaped mass, currant jelly stool) for prompt diagnosis and intervention to prevent bowel ischemia and perforation.
The primary nursing role involves monitoring for signs of shock, preparing the child for a diagnostic and potentially therapeutic enema (air or contrast), and providing post-procedure care, which includes observing for the passage of a normal brown stool, indicating successful reduction.
What if? If the child presents with signs of peritonitis (fever, rigid abdomen, severe tenderness) in addition to symptoms of intussusception, a non-surgical reduction with an enema is contraindicated. The nurse must prepare the child for emergency surgery immediately.

How to Approach the Question

First, analyze the question stem to identify the key descriptive terms: 'telescoping of portion of the intestine' and 'mechanical obstruction'.
Note the word 'imagination' is likely a typo for 'invagination', which is a synonym for the process described.
Evaluate each option based on the definition of intestinal telescoping.
Option A, Hirschsprung's disease, is a motility disorder (functional obstruction), not a telescoping one.
Option B, Aneurysm, is a vascular issue, unrelated to the intestines.
Option C, Enterocolitis, is inflammation, not a mechanical obstruction of this type.

Concept Tested & Keywords

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Practise the full ESIC Nursing Officer 2016 (shift-1)

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