UMEM Educational Pearls

Category: Pediatrics

Title: Intussusception

Keywords: abdominal pain, vomiting, bloody stool, altered mental status, lethargy (PubMed Search)

Posted: 6/22/2012 by Mimi Lu, MD
Click here to contact Mimi Lu, MD


Intussusception is the telescoping or prolapse of one portion of the bowel into an immediately adjacent segment.

  • age: 3 months to 6 years, most common among 3-12 months (although case reports exist in adults)
  • after constipation, most common cause of abdominal pain in infants and pre-school aged children
  • classic triad: colicky abdominal pain, vomiting, and red currant jelly stools
    • occurs in only 10% -20% of cases
  • although colicky pain is the most common symptom, 15-20% experience no pain
  • vomiting is often the earliest symptom, but may be absent in 30-40% cases
  • most patients (75%) without grossly bloody stool, may be positive for occult blood
  • plain abdominal radiographs may be normal in 30% of cases
  • consider in differential for intants with altered mental status/ lethargy
    • TIPS AEIOU - one of the "I"s is for intussusception
  • choice of radiographic evaluation is institution-dependent
    • ultrasound may be diagnostic but is not therapeutic
    • air or contrast enema can diagnose and treat
    • both are operator dependent