Intussusception (2*)

Question 1

What is this?

Where does it commonly occur?

What are the peak ages of its occurrence?

What are its risk factors?

Answer 1

➊ Invagination/telescoping of bowel into itself

➋ Ileocaecal region

➌ 3 months – 2 yrs

➍ • Concurrent viral illness
• Meckel’s diverticulum
• Bowel polyps
• Henoch-Schonlein Purpura
• CF

Question 2

How does it present?

What may be felt O/E?

What are its complications?

Answer 2

➊ • Severe, colicky abdominal pain – Makes child irritable, drawing legs up
• Redcurrant jelly stool
• Pale, lethargic child
• Bilious vomiting
• Bowel obstruction – Absolute constipation, distension

➋ Sausage-shaped mass in RUQ

➌ • Bowel obstruction
• Bowel perforation
• Gangrenous bowel

Question 3

Which investigation should be done?
→ What sign will be seen?

How is it managed?

Answer 3

➊ US
→ Target sign

➋ • Rectal air insufflation or contrast enemas - water or air is pumped into the colon to force the folded bowel to go back to its normal position
• Surgery if non-medical options don’t work or complications occur