Intussusception

Sign & symptoms

• In adults: acute partial intestinal obstruction (<20% of intussusceptions Doughnut sign
cause complete obstruction), abdominal pain. Vomiting, bleeding, and
constipation may be present but often are not. The abdomen may be
distended, and bowel sounds often are decreased.
• In children: the classic triad (abdominal pain, mass, and heme-positive
stools).
Radiology
• Computed Tomography  used in the evaluation of abdominal pain and
bowel obstruction (useful for excluding other DD)
• Ultrasonography  A transverse view of the intussusception has a
donut or target shape, with multiple concentric rings. A longitudinal
view of the intussuscepted segment has an ultrasound appearance
similar to that of a kidney (“pseudo-kidney sign”), with a bright central Pseudo-kidney
area surrounded by a darker outer layer. sign
Ronsen’s Emergency Medicine. 8 th ed.
https://radiopaedia.org/articles/intussusception
 Algorithm & management
• Surgery is required
• ED care:
 Supportive
 Optimizing fluid status
 Recognizing gangrene or perforation
 Administering antibiotics if compromised
bowel is suspected
 Securing surgical consultation in the
appropriate time frame.

Ronsen’s Emergency Medicine. 8 th ed.

The Royal Children’s Hospital Melbourne. Clinical Practice Guidelines. Intussusception. Link at: rch.org.au/clinicalguide/guideline_index/Intussuseption/