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Intussusception

Last reviewed: 9 Aug 2025
Last updated: 31 Jan 2025

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
Detalhes completos

Outros fatores diagnósticos

  • pallor
  • palpable abdominal mass
  • poor feeding
  • abdominal distention
Detalhes completos

Fatores de risco

  • male gender
  • age 2 to 12 months
  • antecedent viral illness
  • first-generation rotavirus vaccination
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • ultrasound
  • abdominal plain-film x-ray
  • diagnostic enema
Detalhes completos

Investigações a serem consideradas

  • CT abdomen
Detalhes completos

Algoritmo de tratamento

AGUDA

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)

CONTÍNUA

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

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

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.
  • Intussusception images
  • Diagnósticos diferenciais

    • Appendicitis (uncommon in this age group)
    • Gastroenteritis
    • Urinary tract infection
    Mais Diagnósticos diferenciais
  • Diretrizes

    • 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 Diretrizes
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