Intussusception

Background

d/t prolapse of part of intestine into the other
90% occurs in childhood (ileocolic, ileocecal, or ileoileocolic), adults can occur (50% are small bowel)
Most common cause of intestinal obstruction in <2 y/o group (2nd cause in infants behind hernia)

Usually btwn 3-12 mos, peak at 10mos (range is 3mo- 2 yr)
Classic triad (3 Sx in 21%, 2Sx in 70%): colicky abdominal pain 80%, vomiting (bilious), bloody stools (currant jelly like) 50%. Intermittent pain= child pulls up knees, then relief.
"Dance's sign"= sausage like RUQ mass with no bowel in RLQ 85%
All labs nonspecific
AXR= signs of obst w/ AFL & no gas distal to obst. U/s gd screening: sensitivity 100% spec.93%
Air contrast enema (replaced barium) can Dx & Rx (do NOT use if pt has peritonitis and/or shock). See coiled spring appearance/cervix lke mass.

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