Intussusception
| Telescoping segment of bowel | |
|---|---|
| Etiology | Invagination of proximal bowel into a distal segment, often ileo-caecal. Lead point ?enlarged Peyer’s patches. In adults - lead point more likely pathological. |
| Epidemiology | Age 3-12 months, with a peak between 5 and 9 months. M>F. Children age>4: longer history ± secondary to pathology e.g. IgA vasculitis |
| Clinical presentation | Colicky abdo pain, bloody stool, bilious vomiting, signs of obstruction |
| Pathogenesis | |
| Diagnostic investigations | If stable and no suspected perforation: USS abdo. sens/spec 98%. Target/doughnut sign; indicative of mesenteric blood flow. |
| Management | Stable patient: Attempt decompression with contrast enema Surgical reduction (open or laparoscopic) |
