Overview

• Invagination of one portion of the bowel into the lumen into adjacent bowel. Most common in ileo-caecal region.
• Typically occurs between 6-18 months old, and is more common in boys.
• Associated Conditions → concurrant viral illness, HSP, CF, intestinal polyps, meckel diverticulum (lead point).
  • Recent viral illness can lead to hypertrophy of Peyer's patches in the small intestine, predisposing to intussusception.

Making Diagnosis

Clinical Features

• Severe colicky abdominal pain.
• Bloodstained ‘redcurrant jelly’ stool.
• RUQ ‘sausage-shaped’ mass.
• Drawing legs up to abdomen.
• Vomiting, lethargy, refusal of feeds.

Investigations

• Ultrasound → target-like mass.

Management Plan

• ABCDE, IV Fluids, NBM, NG tube aspiration.
• 1st Line (if child stable) → rectal air insufflation or reduction via contrast enema.
  • Success rate is 75%. Remaining 25% require an operation.
  • Broad spectrum antibiotics.