CLINICIAN'S CROSSWORD

A bellyache

By Deborah L. Callanan, MD

ACROSS

1. About 60% of inguinal hernias are on this side.

2. This symptom is common to many abdominal complaints.

3. This percentage of intussusceptions recur after nonsurgical therapy.

4. The most common operation performed in children.

5. The most common type of intussusception.

6. X-ray indication for appendectomy.

7. Percentage of appendices perforated at surgery in children younger than 4 years.

8. This stool test is helpful in diagnosing intussusception.

9. Look for this lead point if patient with intussusception is older than 6 years.

10. May be altered in intussusception (two words).

DOWN

11. Found in some incarcerated hernias.

12. This dramatic finding, along with vomiting and episodic pain, constitute the classic triad in intussusception (three words).

13. Percentage of patients with appendicitis who develop perforation within 48 hours.

14. May be felt in right upper quadrant in intussusception.

15. Proportion of patients with appendicitis who have diarrhea.

16. Percentage of patients with intussusception who have two of the three classic findings.

17. This procedure is useful for diagnosing and treating intussusception (two words).

18. Most common reason for surgery for abdominal pain in children younger than 1 year.

19. This condition is often present in history of patients with appendicitis.

20. This procedure is the best way to diagnose appendicitis.

21. Percentage of patients with intussusception with all three classic findings.

22. Percentage of population that develops appendicitis.

23. Most common diagnosis in acute, severe abdominal pain.

24. Decade of life in which appendicitis is most likely.

THE AUTHOR is Attending Physician, Emergency Department, Christus Santa Rosa Children's Hospital, San Antonio, TX, and Clinical Associate Professor of Pediatrics, University of Texas Health Science Center, San Antonio.

Deborah Callanan. Clinician's Crossword: A bellyache.

Contemporary Pediatrics

2000;9:136.