Intussusception

Last reviewed: 28 Apr 2022
Last updated: 07 Apr 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • male gender
  • age 6 to 12 months
  • colicky abdominal pain
  • vomiting
  • lethargy/irritability in between waves of pain
  • blood per rectum/redcurrant jelly stool
  • hypovolemic shock
More key diagnostic factors

Other diagnostic factors

  • pallor
  • palpable abdominal mass
  • poor feeding
  • abdominal distention
Other diagnostic factors

Risk factors

  • male gender
  • age 6 to 12 month
  • antecedent viral illness
  • seasonal variation
  • first-generation rotavirus vaccination
More risk factors

Diagnostic investigations

1st investigations to order

  • ultrasound
  • abdominal plain-film x-ray
  • diagnostic enema
More 1st investigations to order

Investigations to consider

  • CT abdomen
More investigations to consider

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

Jonathan Sutcliffe, MD

Consultant Paediatric Surgeon

Leeds General Infirmary

Leeds

UK

Disclosures

JRS declares that he has no competing interests.

Acknowledgements

Dr Jonathan Sutcliffe would like to gratefully acknowledge Dr David Hackam, Dr Steven C. Gribar, and Dr Rahul J. Anand, the previous contributors to this topic. 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-SPR practice guideline for the performance of pediatric fluoroscopic contrast enema examinations
    More Guidelines
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