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