Intussusception Flashcards
What is intussusception?
It is defined as a condition in which a section of the bowel telescopes into its neighbouring distal section, causing bowel obstruction
Which region of the bowel does intussusception tend to occur?
Ileocecal valve
Which seven risk factors are associated with intussusception?
Infants, 6 – 18 Months Old
Male Gender
Viral Infection
Meckel’s Diverticulum
Intestinal Polyps
Cystic Fibrosis
Henoch-Schoenlein Purpura
What are the ten clincical features of intussusception?
Generally Unwell
Inconsolable Crying
Lethargy
Pallor
Bilious Vomiting
Intermittent Abdominal Pain
Red Currant Jelly Stools
Sausage Right Upper Quadrant Mass
Sunken Eyes
Dry Lips
Describe the abdominal pain associated with intussusception
The abdominal pain episodes result in the child becoming inconsolable and drawing their knees up to their chest
The child may appear well between episodes, however will become more lethargic over time as dehydration worsens
What three investigations are used to diagnose intussusception?
Blood Tests
Abdominal X-Rays
Ultrasound Scans
What two blood test results indicate intussusception?
Increased Neutrophil Levels
Increased CRP Levels
What are the two features of intussusception on abdominal x-ray scans?
Distended Proximal Bowel Loops
Decreased Distal Bowel Gas
What is the gold standard investigation used to diagnose intussusception?
Ultrasound Scans
What is the feature of intussusception on ultrasound scans?
A target-like mass in the right upper quadrant
What are the four immediate management options of intussusception?
IV Analgesia
Fluid Resuscitation
Nasogastric Tube Insertion
Nil By Mouth
What is the most important immediate management option of intussusception?
Fluid Resucitation
What is the non-surgical management option of intussusception?
Enema Administration
When are enemas used to manage intussusception?
They are the first line definitive management option
Name two enemas used to manage intussusception
Water
Air
How is enema administration conducted?
It involves the introduction of air or water into the gut via a foley catheter in the rectum under pressure, in order to force the folded bowel out of the bowel and into the normal position
This is usually conducted under fluoroscopic guidance
What are the two surgical management options of intussusception?
Surgical Reduction
Bowel Resection
When is surgical reduction used to manage intussusception?
It is the second line definitive management option, which is recommended when there is evidence of bowel perforation/peritonitis or when non-surgical management is deemed ineffective
What is surgical reduction?
It involves manual reduction of intussusception, in which the bowel is moved back into its normal position
When is bowel resection used to manage intussusception?
When there is evidence of bowel perforation or bowel necrosis
What five complications are associated with intussusception?
Bowel Obstruction
Bowel Perforation
Bowel Necrosis
Peritonitis
Sepsis
