Intussusception

Background

• Most common cause of intestinal obstruction in 3mo-6yr
  • Usually occurs in 6-18mo
• Due to telescoping of one part of intestine into another
  • Mesentery involvement > ischemia, bloody/mucous stool

Diagnosis

• Triad:
  • Sudden colicky pain
  • Vomiting (bilious)
  • Currant jelly stool (only 50% of cases)
• Intermittent pain
  • Child pulls up knees
  • May be asymptomatic between episodes
• Imaging
  • Ambiguous dx = Ultrasound
  • Likely dx = air contrast enema
    • Diagnostic and frequently curative
• All labs nonspecific

Treatment

1. NPO
2. Surgery consult
3. Air-contrast enema (reduces 80%)

Disposition

Admit