Definition An intussusception is a medical condition where a part of the intestine (intussusceptum) telescopes into another section (intussuscipiens), often leading to bowel obstruction. Etiology 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. Demographics 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. Clinical Presentation “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. Investigations 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. Management 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. Complications Bowel ischemia and necrosis due to compromised blood flow. Peritonitis if the bowel perforates. Recurrence after non-surgical treatment.
