Part of the intestine has invaginated into another section of intestine. This results in venous obstruction and mucosal necrosis.
Incidence begins to rise at about 2-4 months of life, peaks at 12 months, and after age 4 consider pathological lead point
There may be a preceding respiratory or diarrheal illness (not always)
In adults, it is usually associated with some kind underlying GI problems like malignancy
Most common site of idiopathic intussusception is at ileocolic junction.
SIGNS AND SYMPTOMS
Sudden onset of episodicabdominal pain [2-5 times/hour, frequency increases later on][most common in early stages].
Bilious vomiting, diarrhea
Child will pull legs to the chest area and cry
Rectal bleeding (current jelly stool)
Hypovolemic shock is a late sign
Sausage shaped mass in Right Upper Quadrant in cephalocaudal axis
Abdominal X-Ray (best initial test, to rule out obstruction or sign of perforation).
Ultrasound (high sensitivity) - target sign
Air enema (most accurate test). It can also be therapeutic. Air enema is contraindicated in peritonitis.
Viral syndrome (gastrointestinal infections)
NPO, Pain control, IV normal saline (best initial step)
Air contrast enema (best initial management in absence of contraindications)
If perforation present on AXR, the first step is to do the laparotomy, nasogastric intubation on free drainage and give antibiotics (cefazolin, metronidazole) with IV fluids.
EXTRA HIGH YIELD NOTES
Henoch-Scholein Purpura can be associated with Intussusception.
In adults, most common site of intussusception is small bowel or illeo-illeal which often requires surgical correction.
Author: Chirag Navadia MD, Founder of MedRx Education (www.medrx-education.com) Editor: David Spiro MD, MPH, Co-founder of ReelDx (www.reeldx.com) Patient Video: Keith Cross, MD, University of Louisville and Annie Rominger, MD, MSc, University of Louisville Image Source : http://en.wikipedia.org/wiki/Intussusception Last updated on: 06/18/2015