Intussusception

22 September, 2011 by: colinparker

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Intussusception is a ‘telescoping’ of the bowel on itself, commonest in infants between 5 and 10 months of age.  Usually, the classic triad of abdominal pain, vomiting and red-currant-jelly stools is not present, so how do we diagnose this sneaky little condition?

In this episode, we explore the clinical presentation, investigation and management of this bowel-threatening condition.


Outline: Intussusception PEMcast

[cp] intro, disclaimer, background

[cp] History (of the condition)
[rr] Aetiology & Pathophysiology
[sf] Incidence (worldwide)
[cp] incidence in Australia, and at our hospital

[sf] Clinical: History
[rr] Examination findings (caution about triad – usually not the case; highlight pallor – including parental report of)
[cp] Differential diagnoses (including causes of altered conscious state)
[rr] Investigations: AXR
[sf] Investigations: U/S

[cp] Treatment: air enema
[rr] Treatment: surgical reduction

[sf] Complications (including perforation, recurrence)

[all] Summary, goodbye

References & Further Reading

Blanco FC
Intussusception
Medscape Reference
http://emedicine.medscape.com/article/930708-overview

Irish MS
Pediatric Intussusception Surgery
Medscape Reference
http://emedicine.medscape.com/article/937730-overview

Winslow BT, Westfall JM, Nicholas RA.
Intussusception.
Am Fam Physician. 1996 Jul;54(1):213-7, 220. Review. PubMed PMID: 8677837.

Applegate KE.
Clinically suspected intussusception in children: evidence-based review and self-assessment module.
AJR Am J Roentgenol. 2005 Sep;185(3 Suppl):S175-83. Review.
Erratum in: AJR Am J Roentgenol. 2005 Dec;185(6 Suppl):S213. PubMed PMID: 16120899.

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2 Responses to “Intussusception”
  1. colinparker says:

    Thanks to @precordialthump who noticed a fade-out 2 minutes from the end of the audio… You stayed awake! Problem fixed now, you may need to reload the page. Sorry to the other 83 computers/humans that downloaded the dodgy file.

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