2. 9 month old white male T: 99.4 P 110 RR 30 BP: 90/60
presents with his Gen: normal appearing . NAD
HEENT: PERRL, NCAT,
mother. She states that
oropharynx clear
he was playing earlier CV: RRR, no m/r/g
today when suddenly he Pulm: CTAB
began screaming in Abdomen: sausage-shaped mass
pain, followed by an in RUQ, NT, ND
episode of calmness. Ext: 2+ pulses, No c/c/e
This has recurred
multiple times over the
past few hours.
3.
4. 1- Crescent Sign:
intussusception lead
point into gas filled
lumen
2- Target Sign:
Mass in RUQ forms
shape of target,
sometimes just
appears as a mass.
3- Absent RUQ bowel gas
4- Signs of small bowel
obstruction
5. IV & IV fluids
If H&P convincing for Intussusception:
Air Contrast Enema
Notify Surgery prior to study due to risk of perforation
This can be both diagnostic and curative
If H&P is not convincing but still in differential
Ultrasound 1st then Air contrast enema if indicated
This is done as a less invasive method to look for
intussusception and other causes of abdominal pain.
Admit to hospital
Recurrence rate of intussusception is 5-10%
6. Most common intestinal obstruction between 3
months and 6 years of age
“Currant Jelly Stool” is a late manifestation that is only
present in 50% of cases ; (75% have heme-positive
stool)
Should raise concern for intussusception if present but
should have no bearing on decision if absent.
Air contrast enema is both diagnostic and curative
Air is preferred over contrast b/c if perforation occurs no
barium introduced into peritoneum
7. In Left image,
Note the
outline of
bowel
telescoping
proximally.
8. King, Lonnie. Pediatrics, Intussusception.
http://emedicine.medscape.com/article/802424-
overview
Tintanelli’s Emergency Medicine: A Comprehensive
Study Guide. Chapter Chapter 127 Pediatric
Abdominal Emergencies
Wahba, Mark. The Pediatric Abdomen:
Intussusception. www.remergs.com. Oct 9, 2003
http://www.nlm.nih.gov/medlineplus/ency/imagepag
es/1172.htm