Intussusception

An intussusception is a medical condition where a part of the intestine (intussusceptum) telescopes into another section (intussuscipiens), often leading to bowel obstruction.

• Most cases in children are idiopathic.

• Possible triggers in children: Viral infection, Meckel’s diverticulum, or lymphoid hyperplasia post-viral infection.

• In adults: Often due to a structural lesion like a tumour, polyp, or post-surgical adhesion.

• Most common in infants and toddlers, especially between 6 months to 2 years.

• Rarer in adults, where it accounts for a minority of intestinal obstructions.

• “Triad” in children: Colicky abdominal pain, vomiting, and red “currant jelly” stools (blood and mucus mixed).

• Palpable sausage-shaped mass in right upper quadrant.

• Lethargy or altered consciousness due to shock or sepsis.

• Abdominal ultrasound: Most commonly used, shows a characteristic “target” or “doughnut” sign.

• Plain abdominal X-ray: May show signs of obstruction or a mass.

• Contrast enema: Both diagnostic and therapeutic, especially in children.

• Children:

• • Hydrostatic (saline) or air enema: Both diagnostic and therapeutic in uncomplicated cases.
  • Surgery: If enema is unsuccessful, or if there’s a lead point (e.g., Meckel’s diverticulum).
• Adults: Usually require surgery due to a higher likelihood of a pathological lead point.

• Bowel ischaemia and necrosis due to compromised blood flow.

• Peritonitis if the bowel perforates.

• Recurrence after non-surgical treatment.