What is it?
- Common abdominal emergency in children.
- Invagination of a portion of the intestine into itself; most common is
ileocolic (90%) with the lead point proximal to the ileocecal valve.
Who gets it?
- Males>Females 2:1
- 3-12 month-old age group is most common. (range 3mo-3yr)
majority are idiopathic; Can find a lead pt in 5-10% (eg Meckelís, lymphoma, HSP,
polyp (as in Peutz-Jegher syndrome)
- Triad of symptoms:
- Intermittent colicky, crampy abdominal pain (Child may appear
comfortable between episodes).
- Emesis .
- Passage of bloody, mucousy stools. Bloody mucous ("Currant-Jelly") stool
is a late sign resulting from engorgement of the intestine, edema and then
bleeding from the mucosa.
- May also present with MS changes, sausage shaped mass
- X-ray findings:
- Target Sign (akaDoughnut, Bullís Eye): RUQ, just below the liver. Due to
layers of peritoneal fat surrounding and within the intussusception
alternating with layers of mucosa.
- Crescent Sign: Soft-tissue density in LUQ projecting into the colon
- Absent Liver Edge Sign: Liver not easily identified.
Treatment: Barium/Air Enema; 10% recurrence after non-operative reduction
CHLA Board Review 2005