Intussusception: Difference between revisions
| Line 29: | Line 29: | ||
==Disposition== | ==Disposition== | ||
Admit | *Admit | ||
*Recurrence occurs in ~10% of cases reduced by enema | |||
**initial management same | |||
== Source == | |||
Uptodate | |||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:GI]] | [[Category:GI]] | ||
Revision as of 16:14, 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
- Recurrence occurs in ~10% of cases reduced by enema
- initial management same
Source
Uptodate