Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
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- The proximal bowel invaginates into the distal bowel, producing infarction and gangrene of the inner bowel:
- >80% involve the ileocecal region.
- Often occurs with a pathologic lead point in children >2 yr:
- Hypertrophied lymphoid patches may be present in infants.
- Children >2 yr: 1/3 of patients have pathologic lead point.
- Children >6 yr: Lymphoma is the most common lead point.
- Adults usually have a pathologic lead point.
- The most common cause of intestinal obstruction within the 1st 2 yr of life
- Epidemiology in US:
- Most frequently between 5 and 9 mo of age
- Incidence is 2.4 cases per 1,000 live births.
- Male > female predominance of 2:1
- Mortality <1%
- Morbidity increases with delayed diagnosis.
Patients, particularly those in the pediatric age group, with a picture of potential intestinal obstruction, especially with hematest-positive stool or altered mental status, need to have intussusception considered.
- Most cases (85%) have no apparent underlying pathology.
- Predisposing conditions that create a lead point for invagination, esp. in older children and adults:
- Hypertrophied lymphoid patches
- Meckel diverticulum
- Adenovirus or rotavirus infection
- Foreign body
- Henoch–Schönlein purpura
- Celiac disease and cystic fibrosis (small intestine intussusception)