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Intussusception, Emergency Medicine

Roger M. Barkin Reviewed 06/2017
 


Basics

Description

  • The proximal bowel invaginates into the distal bowel, producing infarction and gangrene of the inner bowel:

    • >80% involve the ileocecal region.

  • Often occurs with a pathologic lead po...

Diagnosis

Signs and Symptoms

History

  • Classic triad (present in <50% of patients):

    • Abdominal pain

    • Vomiting, often bilious

    • Stools have blood and mucus (“currant jelly” stools)

  • Recurrent painful episodes ac...

Treatment

Pre-Hospital

  • IV access

  • IV bolus of 20 mL/kg of 0.9% NS or lactated Ringer (LR) if evidence of hypovolemia, abdominal distention, peritonitis, sepsis

  • Diagnosis rarely confirmed in pre-hospital s...

Follow-Up

Disposition

Admission Criteria

  • Patients undergoing successful enema reduction should be observed for complications or recurrence.

  • Patients undergoing surgery

Discharge Criteria

  • May be considered ...

Pearls and Pitfalls

Infants with intermittent abdominal pain, impaired mental status, and blood in stools should generally have intussusception considered. 

Additional Reading

  • Bajaj  L, Roback  MG. Postreduction management of intussusception in a children's hospital emergency department. Pediatrics.  2003;112:1302–1307.

  • Hryhorczuk  AL, Strouse  PJ. Va...

Codes

ICD9

560.0 Intussusception 

ICD10

K56.1 Intussusception 

SNOMED

  • 49723003 Intussusception of intestine (disorder)

  • 197049005 ileocecal intussusception (disorder)

  • 197054001 Secondary intussusception (diso...

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