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A 4-Year-Old Child Is Brought to the Office by Her

Question 29

Multiple Choice

A 4-year-old child is brought to the office by her parents after they see dark red blood on her toilet tissue following a bowel movement. She has experienced no stomach pain, dysuria, or bowel discomfort. The adolescent has no known medical issues and does not use any drugs. The temperature is 36.7 degrees Celsius (98.1 degrees Fahrenheit) , the blood pressure is 100/40 mm Hg, and the pulse rate is 112/min. An examination reveals a soft, nontender abdomen with bowel noises. The hemoglobin concentration is 8 g/dL, and the platelet count is 215,000/mm3. Coagulation tests are common. Using 99mTc-pertechnetate scintigraphy, sequential imaging reveals focused radiotracer accumulation in the right lower quadrant. Which of the following embryologic processes is most likely to have caused this patient's condition?


A) Arrested hindgut descent along the inferior mesenteric artery
B) Defective neural crest cell migration into the bowel wall
C) Disrupted vascular flow to the ileum
D) Failed obliteration of the vitelline duct
E) Partial midgut rotation around the superior mesenteric artery

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