Intussusception

Intussusception is the invagination of a segment of bowel into the distal adjacent bowel. Mostly it involves the distal ileum and proximal colon and no lead point can be identified. It is the most common cause of bowel obstruction in infants and young children. It typically presents in infants between 2 months and 2 years of age with episodic severe colicky abdominal pain, vomiting that progresses to being bilious, abdominal distension, and bleeding per rectum which is classically described as ‘redcurrant jelly’ stool. If not diagnosed and treated promptly the pathology will progress to bowel necrosis, sepsis and death.Patients usually need resuscitation and stabilization before investigation and definite treatment. The diagnostic test of choice is an ultrasound scan of the abdomen. The first-line treatment is an air-reduction enema that will be successful in 80% of cases. Surgery with manual reduction of the intussusception and possible bowel resection is reserved for cases presenting with peritonitis, cases where a pathological lead point is identified, where air-enema failed or where this procedure is complicated by bowel perforation.