top of page

Intussusception

This is where part of the bowel invaginates/telescopes in on itself. It commonly occurs at the ileo-caecal region, and its peak age of onset is 3 months – 2 years.

“Scheme of bowel intussusception. Trapped part of intestine visible as a section, in centre part of picture.” © Olek Remesz CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/)

Risk factors:

  • Concurrent viral illness

  • Meckel’s diverticulum

  • Bowel polyps

  • Henoch-Schonlein Purpura

  • CF


Presentation

  • Severe, colicky abdominal pain – Makes child irritable, drawing legs up

  • Redcurrant jelly stool

  • Pale, lethargic child

  • Bilious vomiting

  • Bowel obstruction – Absolute constipation, distension


O/E - Sausage-shaped mass in RUQ


Investigations

  • Ultrasound - shows Target sign

  • Contrast enema is the most specific for diagnosis, plus it has a therapeutic use

“An ultrasound shows a target sign—characteristic for intussusception” © Benutzer:Kalumet, selbst erstellt CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0/)

Management

  • 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


Complications

  • Bowel obstruction

  • Bowel perforation

  • Gangrenous bowel




bottom of page