Intususseption

Pediatrics, Intussusception

Background: Intussusception is the telescoping or prolapse of one portion of the bowel into an immediately adjacent segment. Contrast enema can reduce the intussusception in approximately 75% of cases.
Pathophysiology: Intussusception most commonly occurs at the terminal ileum (ie, ileocolic). The telescoping proximal portion of bowel (ie, intussusceptum) invaginates into the adjacent distal bowel (ie, intussuscipiens).
The mesentery of the intussusceptum is compressed, and the ensuing swelling of the bowel wall quickly leads to obstruction. Venous engorgement and ischemia of the intestinal mucosa cause bleeding and an outpouring of mucous, which results in the classic description of red 'currant jelly' stool.
Most cases (90%) are idiopathic, with no identifiable lesion acting as the lead point or pathological apex of the intussusceptum.
Frequency:

In the US: Intussusception is the predominate cause of intestinal obstruction in persons aged 3 months to 6 years. The estimated incidence is 1-4 per 1000 live births.
Mortality/Morbidity: Most patients recover if treated within 24 hours.
Mortality with treatment is 1-3%. If left untreated, this condition is uniformly fatal in 2-5 days.
Recurrence is observed in 3-11% of cases. Most recurrences involve intussusceptions that were reduced with contrast enema.
Sex:
Overall, the male-to-female ratio is approximately 3:1.
With advancing age, gender difference becomes marked; in patients older than 4 years, the male-to-female ratio is 8:1.
Age: Intussusception is most common in infants aged 3-12 months, with an average age of 7-8 months.
Two thirds of the cases occur before the patient's first birthday.
Intussusception occurrence is rare in persons

eMedicine - Pediatrics, Intussusception : Article by Lonnie King, MD

posted by Intussusception Medical Care Amateur - @ Intususseption: Pediatrics, Intussusception