Intussusception

Question 1

What does Intussusception involve?

Answer 1

A section of bowel sliding or folding into itself in a telescoping motion

Question 2

Which part of the bowel most does intussusception most commonly occur in?

Answer 2

The ileum enters the caecum

Question 3

Describe the affected section of intestine at point of intussusception

Answer 3

The section is thickened leading to a palpable mass. It has a narrow lumen obstructing the passage of faeces.

Question 4

In which group is intussusception most common?

Answer 4

Boys, infants aged 3 months to 2 years

Question 5

What other conditions may intussusception be associated with?

Answer 5

Viral illnesses (lymph nodes in intestine mesentery swell which triggers point for intussusception)
IgA vasculitis (bowel wall oedema and haemorrhage)
CF
Intestinal polyps
Meckel diverticulum

Question 6

What is the typical presentation of intussusception?

Answer 6

Severe, colicky abdo pain
Bilious vomiting
Redcurrant jelly stool - mix of blood, mucous and stool

Question 7

What is a classic sign of intussuception?

Answer 7

Sausage-shaped mass in the RUQ

(Also redcurrant jelly stool and a preceding URTI)

Question 8

What imaging is done for intussusception and what does it show?

Answer 8

USS
Target or doughnut sign

Question 9

What are the management options for intussusception?

Answer 9

Therapeutic enemas (contrast, water or air pumped into colon to force folded bowel out into normal position)

Surgical reduction

Bowel resection (if gangrene or perforation)