Introduction

Intussusception describes the invagination of one portion of bowel into the lumen of the adjacent bowel, most commonly around the ileo-caecal region.

Epidemiology

  • Incidence: 3.00 cases per 100,000 person-years
  • Most commonly see in infants
  • Sex ratio: more common in males 2:1
Condition Relative
incidence
Infantile colic60.00
Intussusception1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

Features
  • paroxysmal abdominal colic pain
  • during paroxysm the infant will characteristically draw their knees up and turn pale
  • vomiting
  • bloodstained stool - 'red-currant jelly' - is a late sign
  • sausage-shaped mass in the right upper quadrant

Investigations

Investigation
  • ultrasound is now the investigation of choice and may show a target-like mass

Management

Management
  • the majority of children can be treated with reduction by air insufflation under radiological control, which is now widely used first-line compared to the traditional barium enema
  • if this fails, or the child has signs of peritonitis, surgery is performed