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Paediatrics > 2: GI - Intusussception > Flashcards

2: GI - Intusussception Flashcards

1
Q

What is intussusception

A

Portion of small bowel telescopes through distal part causing mechanical obstruction

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2
Q

What is the most common cause of bowel obstruction in children

A

Intusussception

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3
Q

When can intussusception occur

A

5months - 6 years

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4
Q

What is the most common age for intussusception

A

3 months - 12 months

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5
Q

In which gender is intussusception more common

A

Male (3:1)

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6
Q

When is there more likely to be an underlying cause of intussusception

A

<3 months or >5 years

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7
Q

What are four possible causes of intussusception

A
  1. Meckels diverticulum
  2. CF
  3. Oedema of the bowel wall
  4. Intestinal
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8
Q

What is meckel’s diverticulum

A

embryological remanent of the oosomesonephric duct

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9
Q

What is the ‘triad’ of intususcceptibon

A
  1. Abdominal Pain
  2. Sausage shaped mass in RUQ
  3. Red current jelly stools
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10
Q

How will abdominal pain present in intussusception

A

Colicky abdominal pain - child will present pulling their knees up and inconsolable crying

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11
Q

Aside from abdominal pain, what other symptoms are present in intussusception

A

Vomitting

Lethargy

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12
Q

What is a sign of intussusception

A

Palpable sausage-shaped mass in RUQ

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13
Q

What can be auscultated in intussusception and why

A

Tinkling bowel sounds - caused by obstruction

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14
Q

What is a late sign of intussusception

A

Red currant jelly stools

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15
Q

What is the commonest site for intususception

A

Ileocaecal valve

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16
Q

Explain pathophysiology of intususcception

A

Telescoping of the bowel through a distal portion obstructions the lymphatics causing oedema. This occludes the vascular supply causing vascular ischaemia. As the bowel mucosa is furthest from blood supply it sloughs off risking perforation.

17
Q

What is first-line investigation for intussusception

A

Abdominal US with enema

18
Q

What will be seen on abdominal US in intussusception

A

Target sign

19
Q

What is first line management of intususcception and why

A

NG tube and fluids (drip and suck). NG tube is to relieve obstruction. Fluid - to prevent hypovolaemic shock caused by blood pooling.

20
Q

What is used to treat intusussception

A

Rectal air insufflation

21
Q

When can rectal air insufflation not be used to manage intususception

A

If evidence of peritonitis

22
Q

What is used if rectal air insufflation is ineffective or peritonitis present

A

Surgical repair

23
Q

What are four complications of intususcception

A
  1. Small Bowel Obstruction
  2. Gangrene due to sepsis
  3. Perforation
  4. Peritonitis

Paediatrics (61 decks)

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