2022 Intussusception (Smarty PANCE)Answered

What is intussusception of the bowel? Intussusception is the invagination of a proximal segment of the bowel into the portion just distal to it. Is intussusception more common in children or adults? It occurs most commonly in children (95% of cases), generally following a viral infection What type of stool is pathognomonic for intussusception? Currant jelly stool What is the most common known cause of intussusception in children? The most common known cause of intussusception in children is lymphoid hyperplasia What is the most common cause of intussusception in adults? The most common cause of intussusception in adults is a tumor Where is the most common location for an intussusception? The most common location for intussusception is at the ileocecal junction What are the initial symptoms of intussusception? The initial symptoms are sudden onset of significant, colicky abdominal pain that recurs every 15 to 20 min, often with vomiting. Paroxysmal abdominal pain is the main symptom. The child appears relatively well between episodes or may appear lethargic. What are the late symptoms of intussusception? Later, as intestinal ischemia develops, pain becomes steady, the child becomes more lethargic, and mucosal hemorrhage causes heme-positive stool on rectal examination and sometimes the spontaneous passage of a currant jelly stool. What may be felt on physical examination in intussusception? A sausage-like mass may be felt on abdominal exam What is the treatment of adults with intussusception? Adults generally require surgery What is used for both the diagnosis and treatment of intussusception in children? In children, barium or air enema may be both diagnostic and therapeutic. In adults, barium enema should not be used. For adults, barium enema should not be used, and abdominal plain-film radiography shows nonspecific obstruction. CT is the best means of establishing the diagnosis, but many cases are diagnosed only at surgery. What will be seen on abdominal US in intussusception? Intussusception has a bull's-eye appearance on ultrasound. What will be seen on abdominal x-ray in intussusception? An abdominal x-ray will reveal a “Crescent sign” or a “Bull's eye/target sign/coiled spring lesion” representing layers of the intestine within the abdomen