Summary
Definição
História e exame físico
Principais fatores diagnósticos
- presence of risk factors
- male gender
- age 2 to 12 months
- colicky abdominal pain
- vomiting
- lethargy/irritability in between waves of pain
- blood per rectum/red currant jelly stool
- hypovolemic shock
Outros fatores diagnósticos
- pallor
- palpable abdominal mass
- poor feeding
- abdominal distention
Fatores de risco
- male gender
- age 2 to 12 months
- antecedent viral illness
- first-generation rotavirus vaccination
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- ultrasound
- abdominal plain-film x-ray
- diagnostic enema
Investigações a serem consideradas
- CT abdomen
Algoritmo de tratamento
clinically stable with no contraindications to contrast enema reduction
with contraindications to contrast enema reduction and/or clinically unstable (e.g., shock, suspected perforation, peritonitis, evidence of bowel wall necrosis)
recurrence
Colaboradores
Autores
Eduardo A Perez, MD
Professor of Surgery
DeWitt Daughtry Family Department of Surgery
Pediatric Adolescent Surgery
Miller School of Medicine
University of Miami
Miami
FL
Declarações
EAP declares that he has no competing interests.
Carlos Theodore Huerta, MD
DeWitt Daughtry Family Department of Surgery
Pediatric Adolescent Surgery
Miller School of Medicine
University of Miami
Miami
FL
Declarações
CH declares that he has no competing interests.
Agradecimentos
Dr Eduardo A Perez and Dr Carlos Huerta would like to gratefully acknowledge Dr Jonathan Sutcliffe, Dr David Hackam, Dr Steven C. Gribar, and Dr Rahul J. Anand, the previous contributors to this topic. JS, DH, SCG, and RJA declare that they have no competing interests.
Revisores
Oliver Soldes, MD
Staff Surgeon
Department of Pediatric Surgery
Cleveland Clinic Foundation
Cleveland
OH
Declarações
OS declares that he has no competing interests.
Lewis Spitz, MBChB, PhD, FRCS, MD, FRCPCH, FAAP, FACS
Emeritus Nuffield Professor of Paediatric Surgery
Institute of Child Health
University College
London and Great Ormond Street Hospital NHS Trust
London
UK
Declarações
LS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
American College of Radiology. ACR Appropriateness Criteria: Vomiting in Infants. 2020 [internet publication].Texto completo
Gluckman S, Karpelowsky J, Webster AC, et al. Management for intussusception in children. Cochrane Database Syst Rev. 2017 Jun 1;6:CD006476. Resumo
American College of Radiology. ACR-SPR practice parameter for the performance of pediatric fluoroscopic contrast enema examinations. 2021 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Appendicitis (uncommon in this age group)
- Gastroenteritis
- Urinary tract infection
Mais Diagnósticos diferenciaisDiretrizes
- ACR-SPR practice parameter for the performance of pediatric fluoroscopic contrast enema examinations
- ACR Appropriateness Criteria: vomiting in infants up to 3 months of age
Mais DiretrizesConectar-se ou assinar para acessar todo o BMJ Best Practice
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