Intussusception

Question 1

What is Intussusception?

Answer 1

It is the invagination of one portion of bowel into the lumen of the adjacent bowel, most commonly around the ileo-caecal region

Question 2

Who does intussusception affect?

Answer 2

It usually affects infants between 6-18 months old. Boys: Girls 2:1.

Question 3

What are the features of intussusception?

Answer 3

• paroxysmal abdominal colic pain
• during paroxysm the infant will characteristically draw their knees up and turn pale
• vomiting
• bloodstained stool - ‘red-currant jelly’ - is a late sign
• sausage-shaped mass in the right upper quadrant

Question 4

How would you investigate itussusception?

Answer 4

Via ultrasound as may show a target-like mass

Question 5

How would you manage Intussesception?

Answer 5

• the majority of children can be treated with reduction by air insufflation under radiological control, which is now widely used first-line compared to the traditional barium enema
• if this fails, or the child has signs of peritonitis, surgery is performed