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Intussusception

Last reviewed: 1 Nov 2024
Last updated: 04 Jun 2024

Summary

Definition

History and exam

Key diagnostic factors

  • 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
Full details

Other diagnostic factors

  • pallor
  • palpable abdominal mass
  • poor feeding
  • abdominal distention
Full details

Risk factors

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

Diagnostic tests

1st tests to order

  • ultrasound
  • abdominal plain-film x-ray
  • diagnostic enema
Full details

Tests to consider

  • CT abdomen
Full details

Treatment algorithm

ACUTE

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)

ONGOING

recurrence

Contributors

Authors

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

Disclosures

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

Disclosures

CH declares that he has no competing interests.

Acknowledgements

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.

Peer reviewers

Oliver Soldes, MD

Staff Surgeon

Department of Pediatric Surgery

Cleveland Clinic Foundation

Cleveland

OH

Disclosures

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

Disclosures

LS declares that he has no competing interests.

  • Intussusception images
  • Differentials

    • Appendicitis (uncommon in this age group)
    • Gastroenteritis
    • Urinary tract infection
    More Differentials
  • Guidelines

    • 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
    More Guidelines
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