ppt

1. INTUSSUSCEPTION
Lecture by
DR. MUHAMMAD AFZAL CHAUDHARY
MBBS (Dow). FCPS.
Consultant Gen & Laparoscopic Surgeon

2. The Anatomy of Intussusception
• Intussusception occurs when
a segment of bowel , the
Intussusceptum , telescopes
into a more distant segment
of bowel .
• The most common type is
ileocolic , followed by ,
and colocolic.

3. Epidemiology
• Most common acute abdominal disorder of early
childhood.
• Boys affected 4 times more frequently than girls.
• Majority of patients between 3 mon and 3 yr.
- Pick incidence between 5 mon and 9 month.
- 75% under 2 years.
• Seasonal peaks in spring and autumn.
• 95% have no pathologic lead point.

4. Etiology
)
.
• Idiopathic (<3): no defined lead point.
- Association with viral illness( adenovirus
- Hypertrophy of lymphoid tissue.
• Recognizable cause for lead point
- Meckel ‘s diverticulum(the most common)..
- Intestinal polype.
- Enteric duplication.
- Lymphoma.
- Intramural hematoma.
- Henoch-Shonlein purpura.

5. Clinical Features
• Intermittent , colicky cramping pain .
• lethargy and somnolence.
• Vomiting (may be bile-stained).
• Currant jelly stool (blood and mucus).
• Sausage shaped mass.
• Distention and tenderness.
• Additional signs : irritability, nausea ,fever ,
and anorexia.

6. Classic clinical triad
• abdominal pain
• currant jelly
stool.
• vomiting.

7. PHYSICAL EXAM
• Lethargic with colicky pattern of
abdominal pain
• Mass in the RUQ may be palpated (“RUQ
sausage”)
• Absence of bowel contents in right
lower quadrant (Dance sign)
• Abdominal distention
• Rectal exam: Blood-tinged mucous or
currant jelly stool
• Peritoneal signs.

8. Dance sign