Intussusception: Difference between revisions
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==Background== | ==Background== | ||
* d/t prolapse of part of intestine into the other | * d/t prolapse of part of intestine into the other | ||
* 90% occurs in childhood (ileocolic, ileocecal, or ileoileocolic), adults can occur (50% are small bowel) | * 90% occurs in childhood (ileocolic, ileocecal, or ileoileocolic), adults can occur (50% are small bowel) | ||
* Most common cause of intestinal obstruction in <2 y/o group (2nd cause in infants behind hernia) | * Most common cause of intestinal obstruction in <2 y/o group (2nd cause in infants behind hernia) | ||
==Diagnosis== | ==Diagnosis== | ||
* Usually btwn 3-12 mos, peak at 10mos (range is 3mo- 2 yr) | * Usually btwn 3-12 mos, peak at 10mos (range is 3mo- 2 yr) | ||
* Classic triad (3 Sx in 21%, 2Sx in 70%): colicky abdominal pain 80%, vomiting (bilious), bloody stools (currant jelly like) 50%. Intermittent pain= child pulls up knees, then relief. | * Classic triad (3 Sx in 21%, 2Sx in 70%): colicky abdominal pain 80%, vomiting (bilious), bloody stools (currant jelly like) 50%. Intermittent pain= child pulls up knees, then relief. | ||
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* AXR= signs of obst w/ AFL & no gas distal to obst. U/s gd screening: sensitivity 100% spec.93% | * AXR= signs of obst w/ AFL & no gas distal to obst. U/s gd screening: sensitivity 100% spec.93% | ||
* Air contrast enema (replaced barium) can Dx & Rx (do NOT use if pt has peritonitis and/or shock). See coiled spring appearance/cervix lke mass. | * Air contrast enema (replaced barium) can Dx & Rx (do NOT use if pt has peritonitis and/or shock). See coiled spring appearance/cervix lke mass. | ||
==Treatment== | ==Treatment== | ||
#npo | |||
#NGT | |||
#IVF | |||
#surgery consult | |||
#Air-Contrast enema (reduces 80%) | |||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:GI]] | |||
Revision as of 21:11, 7 June 2011
Background
- d/t prolapse of part of intestine into the other
- 90% occurs in childhood (ileocolic, ileocecal, or ileoileocolic), adults can occur (50% are small bowel)
- Most common cause of intestinal obstruction in <2 y/o group (2nd cause in infants behind hernia)
Diagnosis
- Usually btwn 3-12 mos, peak at 10mos (range is 3mo- 2 yr)
- Classic triad (3 Sx in 21%, 2Sx in 70%): colicky abdominal pain 80%, vomiting (bilious), bloody stools (currant jelly like) 50%. Intermittent pain= child pulls up knees, then relief.
- "Dance's sign"= sausage like RUQ mass with no bowel in RLQ 85%
- All labs nonspecific
- AXR= signs of obst w/ AFL & no gas distal to obst. U/s gd screening: sensitivity 100% spec.93%
- Air contrast enema (replaced barium) can Dx & Rx (do NOT use if pt has peritonitis and/or shock). See coiled spring appearance/cervix lke mass.
Treatment
- npo
- NGT
- IVF
- surgery consult
- Air-Contrast enema (reduces 80%)