Intussesception

Question 1

What is the most common cause of intestinal obstruction in children?

Answer 1

Intussusception

Question 2

What is this describing?

A section of small bowel invaginates, like a telescope.

Answer 2

Intussusception

Question 3

Where does an intussusception normally take place and what does it cause locally?

Answer 3

1. Terminal ileum - invaginates into the caecum, taking the mesentery with it.
2. Oedema, ischaemia, necrosis, perforation.

Question 4

What is this a presentation of?
Episodic, intermittent inconsolable crying with drawing the legs up (colic), acute/subacute, vomiting, pallor. Blood in PR, sausage shaped abdominal mass may be felt in RLQ.

Answer 4

Intussesception

Question 5

How is intussusception diagnosed?

Answer 5

USS shows a target shaped mass (doughnut sign)

Question 6

What is the management for intussusception?

Answer 6

1. If haemodynamically stable - reduced by an air oedema.

2. Surgical laparotomy if air enema fails/perforation/symptoms >24 hours.