ROSH Gastrointestinal Practice Exam

What is the most common cause of intestinal obstruction in children under two years of age?

1. Adhesions

2. Incarcerated inguinal hernia

3. Intussusception

4. Malrotation with midgut volvulus

The correct answer is: Intussusception

Intussusception is indeed the most common cause of intestinal obstruction in children under two years of age due to several key factors. Intussusception occurs when a segment of the intestine telescopes into an adjacent segment, which can lead to obstruction and compromised blood supply to the affected area. In young children, especially those between the ages of six months and three years, intussusception is often idiopathic, meaning the exact cause is not always identified. However, it can be associated with conditions such as viral infections that lead to increased peristalsis or the presence of lymphoid hyperplasia, particularly in the ileocecal region. While adhesions, incarcerated inguinal hernias, and malrotation with midgut volvulus are potential causes of obstruction, they are less common in this specific age group. Adhesions are typically more associated with previous surgeries, which are less frequent in infants. An incarcerated inguinal hernia can occur but is not as prevalent as intussusception in this age group. Malrotation and volvulus tends to be a more severe condition generally presenting in the neonatal period but less often than intussusception beyond the newborn phase. Overall, the prevalence, clinical presentation, and age demographics support int