Intussusception is the invagination (or telescoping) of one part of bowel into another.
Most typically it involves the ileum into the caecum however can occur anywhere in the bowel.
The risk is ischemia of the ‘trapped’ bowel leading to necrosis and sepsis.
It may occur at any age but commonly occurs in the 2 month to 2 year age group with a peak incidence at 5 to 9 months.
Most common cause of bowel obstruction in children < 3yr old. M > F
Fatal if untreated.
The ileum has invaginated into the cecum.
The cecum is called the intussuscipiens.
The ileum is called the intussusceptum.
Intussusception ‘pseudo kidney’ sign.
The ileum is the intussuseptum and has telescoped into the caecum (intussusipiens).
Axial CT scan showing the intussusception in the RIF.
Coronal CT scan showing the intussusception in the RIF.
Clinical flowchart for intussusception.
REF: The Royal Children’s Hospital, Melbourne Australia.
Patho-physiology of Intussusception
In a small percentage, there may be a ‘lead point’. This is an anatomical or pathological structure contributing the the intussuseption. EG tumour, meckles diverticulum or haematoma. Non surgical resolution is less successful when a lead point is present.