Intussusception

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    • Intussusception
      • Invagination of one portion of the bowel into itself—proximal portion usually drawn into distal portion by peristalsis.
      • Male-to-female ratio: 2:1 to 4:1
      • Peak incidence – 5 to 12 months
      • Age range: 2 months to 5 years
      • Causes
        • Idiopathic.
        • Viral (enterovirus in summer, rotavirus in winter).
        • A “lead point” (or focus) is thought to be present in older children
        • These lead points can be caused by:
          • Meckel’s diverticulum ,Polyp ,Lymphoma
          • Henoch–Schönlein purpura  ,Cystic fibrosis
      • Signs and symptoms
        • Classic triad:
          • Intermittent colicky abdominal pain
          • Bilious vomiting
          • Currant jelly stool
        • Neurologic signs:
          • Lethargy
          • Shock-like state
          • Seizure-like activity
          • Apnea
        • RUQ mass:
          • Sausage shaped
          • Ill defined
          • Dance’s sign—absence of bowel in right lower quadrant (RLQ)
      • DIAGNOSIS
        • AXR:
          • Paucity of bowel gas
          • Loss of visualization of the tip of liver
          • “Target sign”—two concentric circles of fat density
        • Ultrasound:
          • “Target” or “donut” sign
            • single hypoechoic ring with hyperechoic center
          • “Pseudokidney” sign —
            • superimposed hypoechoic (edematous walls of bowel) and hyperechoic (areas of compressed mucosa) layers
        • Barium enema
      • Treatment
        • Correct dehydration
        • NG tube for decompression
        • Hydrostatic reduction
        • Barium enema:
          • Cervix-like mass
          • Coiled spring appearance on the evacuation film
          • Contraindications:
            • Peritonitis
            • Perforation
            • Profound shock
        • Air enema:
          • Decreased radiation
          • Fewer complications
      • RECURRENCE
        • With radiologic reduction: 7–10%
        • With surgical reduction: 2–5%
      • Clinical Pearls :
        • Most common cause of acute intestinal obstruction under 2 years of age.-Intusussception
        • Most common site is ileocolic (90%).
        • Intussusception and link with rotavirus vaccine led to withdrawal of vaccine from the market.
        • Intussusception:
          • Classic triad is present in only 20% of cases.
          • Absence of currant jelly stool does not exclude the diagnosis.
          • Neurologic signs may delay the diagnosis.
        • Barium enema for intussusception is both diagnostic and therapeutic.
        • Rule of threes:
          • Barium column should not exceed a height of 3 feet
          • No more than three attempts
          • Only 3minutes/attempt


    Intussusception
    Intussusception of the Bowel
    Intussusception of the small intestine in a patient with previous Roux-en-y bariatric surgery. Concept of intestinal peristalsis. Recurrent intussusception with spontaneous resolution.
    Intussusception: Symptoms, Diagnosis and Treatment
    intussusception surgery
    5mth baby with intussusception,ileo-ileal+ileo-colic+co­lo-colic
    Intussusception
    An intussusception is a medical condition in which a part of the intestine has invaginated into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another
    COMLEX Minute Intussusception
    An intussusception is a medical condition in which a part of the intestine has invaginated into another section of intestine.
    Laparoscopic Surgery For Ileal Intussusception In Adult
    This was an acute onset of abdominal pain with obstructive symptoms in 25 years male, ultrasound showing a 15 cm long Ileal intussusception, which was released by laparoscopic technique and an intra Ileal fibromatous lesion excised and ileal rent sutured and procedure completed by Laparoscopic technique.
    Intussusception