INTUSSUSCEPTION Flashcards

1
Q

Facts: Pathophysiology, Epi

A

6 Mo - 6 Yrs

Segment of bowel (MC ileocolic) telescopes into the distal bowel -> venous congestion + edema -> bowel ischemia -> necrosis + perforation

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2
Q

Clinical Features

A

Ask about:

TRIAD (1/3 of cases):

  • colicy abdominal pain: severe, episodic, symptom free periods
    -currant jelly stool (late)
    -vomit

a/w:
+/- vomit
+/- lethargy

Recent viral or diarrheal illness

Look for:
- sausage shaped mass
-abdominal distension

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3
Q

Investigations

A

CBC, comprehensive metabolic panel, and type and screen

U/S: Test of Choice
Sensitive 98-100%
-Doughnut Sign

Plain XRAY:
-if concern for obstruction /perforation
-Supine, upright / cross-table lateral views

  • Target Sign
  • Crescent Sign or Meniscus Sign
  • Soft Tissue Mass RUQ
  • Obscured Liver Edge
  • Signs of Obstruction
  • Free Air
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4
Q

Management

A

IVF: 20 cc/kg bolus of NS

Maintenance Fluid

NPO

Surgical Consult if signs of perforation, shock or peritonitis

Non-surgical reduction by radiologist with air or contrast enema. Success > 90%

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