- 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 first 2 yr of life
- Epidemiology in the U.S.:
- Most frequently between 5–9 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 children <3 mo, those >5 yr of age and adults:
- Hypertrophied lymphoid patches
- Meckel diverticulum
- Adenovirus or rotavirus infection
- Foreign body
- Henoch–Schönlein purpura
- Celiac disease and cystic fibrosis (small intestine intussusception)
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Schaider, Jeffrey J., et al., editors. "Intussusception." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307375/all/Intussusception.
Intussusception. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307375/all/Intussusception. Accessed June 4, 2023.
Intussusception. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307375/all/Intussusception
Intussusception [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 June 04]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307375/all/Intussusception.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Intussusception ID - 307375 ED - Barkin,Adam Z, ED - Shayne,Philip, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307375/all/Intussusception PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -