paeds surgery

Question 1

what is intussusception?

Answer 1

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

Question 2

at what ages does intussusception usually present?

Answer 2

between 6-18 months old

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

what ix do you do for intussusception?

Answer 4

USS, target-like mass

Question 5

how is intussusception managed?

Answer 5

• 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