Intussusception: Difference between revisions
| Line 6: | Line 6: | ||
==Diagnosis== | ==Diagnosis== | ||
*Triad: | *Classic Triad: | ||
**Sudden colicky pain | **Sudden colicky pain | ||
** | **Palpable sausage shaped mass on Right | ||
**Currant jelly stool (only 50% of cases) | **Currant jelly stool (only 50% of cases) | ||
*Intermittent pain | *Intermittent episodes of pain | ||
**Child pulls up knees | **Child pulls up knees | ||
**May be asymptomatic between episodes | **May be asymptomatic between episodes | ||
**Later stages may be associated with lethargy | |||
*Imaging | *Imaging | ||
** | **Ultrasound | ||
** | ***Sensitivity and specificity approach 100%, but operator dependent | ||
***Classically see bulls eye lesion | |||
**Air contrast enema | |||
***Diagnostic and frequently curative | ***Diagnostic and frequently curative | ||
***Prior to procedure, IV hydration, NG tube decompression, surgery consult | |||
*All labs nonspecific | *All labs nonspecific | ||
Revision as of 16:03, 28 October 2011
Background
- Most common cause of intestinal obstruction in 3mo-6yr
- Usually occurs in 3-36 months
- Due to telescoping of one part of intestine into another
- Mesentery involvement > ischemia, bloody/mucous stool
Diagnosis
- Classic Triad:
- Sudden colicky pain
- Palpable sausage shaped mass on Right
- Currant jelly stool (only 50% of cases)
- Intermittent episodes of pain
- Child pulls up knees
- May be asymptomatic between episodes
- Later stages may be associated with lethargy
- Imaging
- Ultrasound
- Sensitivity and specificity approach 100%, but operator dependent
- Classically see bulls eye lesion
- Air contrast enema
- Diagnostic and frequently curative
- Prior to procedure, IV hydration, NG tube decompression, surgery consult
- Ultrasound
- All labs nonspecific
Treatment
- NPO
- Surgery consult
- Air-contrast enema (reduces 80%)
Disposition
Admit