Exophthalmos may occur in children with what diagnosis?

The correct answer is choice D. "Currant jelly" stools.

Choice A rationale:

Loose, foul-smelling stools are not characteristic of intussusception. Intussusception is a condition in which a part of the intestine invaginates into another part, causing obstruction. This obstruction often leads to "currant jelly" stools, which are composed of mucus, blood, and sloughed intestinal tissue. Loose stools might be associated with other gastrointestinal issues but are not a hallmark of intussusception.

Choice B rationale:

Ribbon-like stools are characteristic of intussusception. When a section of the intestine telescopes into another section, it can cause the stool to be squeezed into a ribbon-like shape as it passes through the narrowed portion. This description aligns with the pathophysiology of intussusception.

Choice C rationale:

Hard stools positive for guaiac indicate the presence of blood in the stool, but this finding is not specific to intussusception. Guaiac testing detects occult blood, which could be present in various gastrointestinal conditions, including bleeding ulcers or diverticulitis, and not exclusively in intussusception.

Choice D rationale:

"Currant jelly" stools are characteristic of intussusception. As mentioned earlier, these stools are the result of the obstruction and subsequent damage to the intestinal lining, leading to the presence of blood, mucus, and sloughed tissue. This description is a classic sign of intussusception and should raise suspicion for this condition.

The correct answer is Choice A: Surgical removal of the affected section of bowel.

Choice A rationale:

Surgical removal of the affected section of bowel is the primary therapeutic management for most children with Hirschsprung's disease. Hirschsprung's disease is a congenital condition where there is a lack of nerve cells in a segment of the colon, leading to obstruction and dilation of the bowel. Surgical resection of the affected segment and reconnection of healthy bowel portions is the standard treatment to alleviate the obstruction and restore normal bowel function.

Choice B rationale:

Daily enemas might be used in some cases to manage symptoms temporarily, but they are not the primary therapeutic management for Hirschsprung's disease. Surgery is the mainstay of treatment.

Choice C rationale:

Permanent colostomy might be considered if the affected portion of bowel is extensive and cannot be safely reconnected after resection, but it's not the primary option for most children with Hirschsprung's disease.

Choice D rationale:

A low-fiber diet is not a therapeutic management for Hirschsprung's disease. Surgical intervention is necessary to address the underlying cause of obstruction, and diet modifications alone wouldn't resolve the condition.