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General Medicine

Intussusception

Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Invagination (telescoping) of a portion of intestine into itself

    • May involve any part of small intestine or ileocolic (95%) or colocolic segment

  • System(s) affected: gastrointestinal ...

DIAGNOSIS

HISTORY

  • History of intermittent colicky abdominal pain

    • Episodes lasting 5 to 10 minutes

    • Often completely asymptomatic between episodes

  • Most have vomiting.

  • History of bloody stool (“currant jell...

TREATMENT

GENERAL MEASURES

  • IV fluid resuscitation

  • Foley catheter (if severely dehydrated)

  • Nasogastric tube

  • Antibiotics if necrotic bowel present

  • Surgical consultation (3)[A]

  • Nonoperative care (1),(3)[A]

    • Hy...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Monitor patients who need surgical reduction for postoperative complications. 

Patient Monitoring

Office visit 1 to 2 weeks after discharge 

DIET

Progress diet as tol...

REFERENCES

1
Ito Y, Kusakawa I, Murata Y, et al. Japanese guidelines for the management of intussusception in children, 2011. Pediatr Int.  2012;54(6):948–958. [View Abstract on OvidMedline]
2
Marin...

ADDITIONAL READING

  • Adekunle-Ojo A, Craig A, Ma L, et al. Intussusception: postreduction fasting is not necessary to prevent complications and recurrences in the emergency department observation unit. ...

SEE ALSO

Cystic Fibrosis; Henoch-Schönlein Purpura; Intestinal Obstruction 

CODES

ICD10

K56.1 Intussusception 

ICD9

560.0 Intussusception 

SNOMED

  • 49723003 Intussusception of intestine (disorder)

  • 17186003 Ileocolic intussusception

  • 27673007 Intussusception of colon

CLINICAL PEARLS

  • The classic presentation for intussusception is intermittent infantile abdominal pain, vomiting, and currant jelly stools with a palpable right lower quadrant mass following an upper r...

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Related Images
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FIG. 2.64. Colonic intussusception. Axial T2-weighted image demonstrates layers of sigmoid colonic intussusception with outer colon wall (arrow), pericolonic fat (arrowhead), and inner colon wall (thin arrow).
FIG. 2.64. Colonic intussusception. Axial T2-weighted image demonstrates layers of sigmoid colonic intussusception with outer colon wall (a...
FIG. 8.11. Intussusception. A: Currant jelly stool characteristic of intussusception. B: Ileocolic intussusception. Barium enema shows the intussusception as the filing defect within the hepatic flexure surrounded by spiral mucosal folds. Significant distended small bowel represents distal small bowel obstruction.
FIG. 8.11. Intussusception. A: Currant jelly stool characteristic of intussusception. B: Ileocolic intussusception. Barium enema shows the ...
FIG. 8.11. Intussusception. A: Currant jelly stool characteristic of intussusception. B: Ileocolic intussusception. Barium enema shows the intussusception as the filing defect within the hepatic flexure surrounded by spiral mucosal folds. Significant distended small bowel represents distal small bowel obstruction.
FIG. 8.11. Intussusception. A: Currant jelly stool characteristic of intussusception. B: Ileocolic intussusception. Barium enema shows the ...
Figure 15-5 Pathologic intussusception. The proximal (swallowed) segment is to the right; the distal (swallowing) segment is to the left. The discolored segment is hemorrhagic infarction.
Figure 15-5 Pathologic intussusception. The proximal (swallowed) segment is to the right; the distal (swallowing) segment is to the left. T...
Fig GI 36-15 Intussusception. Obstruction of the colon at the hepatic flexure. Note the characteristic coiled-spring appearance.
Fig GI 36-15 Intussusception. Obstruction of the colon at the hepatic flexure. Note the characteristic coiled-spring appearance.
FIGURE 12-8. Intestinal obstruction. (A) Intussusception. (B) Volvulus, showing counterclockwise twist.
FIGURE 12-8. Intestinal obstruction. (A) Intussusception. (B) Volvulus, showing counterclockwise twist.
Intusseption. The distal ileal segment of bowel has invaginated into the cecum. A polyp serves as lead point.
Intusseption. The distal ileal segment of bowel has invaginated into the cecum. A polyp serves as lead point.
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