A 28-year old male with no past medical history presents with ches tpain for 2 days. The pain is pressure-like in the center of his ches tand worse with deep inspiration. He states he just got over a cold but denies recent fever or cough. An EKG is obtained. What is the diagnosis?
-One segment of intestine telescopes into another
-Most commonly ileum into colon
-Most common cause of intestinal obstruction in children under 2 y/o
-Rare before 2 months old
-Classically infant with intermittent episodes of severe abdominal pain with legs drawn to chest, asymptomatic between episodes
-Classic Triad: abdominal pain, palpable sausage shaped abdominal mass, bloody stools (“currant jelly”)
- rarely all 3 present
Pathology: Chronic autoimmune mucocutaneous disease against desmosomes in epidermis
- painful; rarely pruritic; afebrile
- flaccid bullae but may start tense, +Nikolsky's sign
- mucosal involvement common
- Bullous pemphigus: Have tense bullae (may start with urticarial lesions), negative Nikolsky's sign, mucosal involvement less likely
Diagnosis: clinical; biopsy is gold standard.