eMedicine Specialties > Emergency Medicine > Pediatric

Pediatrics, Intussusception: Differential Diagnoses & Workup

Author: Lonnie King, MD, Consulting Staff, Department of Emergency Medicine, Children's Healthcare of Atlanta at Scottish Rite
Contributor Information and Disclosures

Updated: Aug 12, 2009

Differential Diagnoses

Abdominal Trauma, Blunt
Appendicitis, Acute
Hernias
Pediatrics, Gastroenteritis
Testicular Torsion

Other Problems to Be Considered

Adhesive band
Volvulus
Meckel diverticulum
Any process causing abdominal pain or GI bleeding

Workup

Laboratory Studies

  • Perform laboratory studies as needed for the febrile, dehydrated, or unstable patients with intussusception.

Imaging Studies

  • If intussusception is strongly suspected, perform a contrast enema without delay. This is contraindicated in patients with an obvious surgical abdomen (eg, signs of peritonitis or perforation) and in unstable patients.
  • Plain abdominal radiographic findings may be normal early in the disease or may show perforation, typical obstructive pattern, or soft tissue mass of the intussusception on the right side. A paucity of gas in the right upper quadrant may be present.
  • Ultrasonography has been used to diagnose intussusception. A recent study examined the use of ultrasonography as a primary modality to assess ileocolic intussusception.2 The study reported that the overall sensitivity for detecting intussusception was 97.9% and the specificity was 97.8%. The authors concluded that ultrasonography should be used as a first-line examination for the assessment of possible pediatric intussusception.

More on Pediatrics, Intussusception

Overview: Pediatrics, Intussusception
Differential Diagnoses & Workup: Pediatrics, Intussusception
Treatment & Medication: Pediatrics, Intussusception
Follow-up: Pediatrics, Intussusception
Multimedia: Pediatrics, Intussusception
References
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References

  1. Sanni RB, Nandiolo R, Coulibaly Diaoudia MT, Vodi L, Mobiot ML. Acute intussusception due to intestinal Kaposi's sarcoma in an infant. Afr J Paediatr Surg. Jul-Dec 2009;6(2):131. [Medline].

  2. Hryhorczuk AL, Strouse PJ. Validation of US as a first-line diagnostic test for assessment of pediatric ileocolic intussusception. Pediatr Radiol. Aug 6 2009;[Medline].

  3. Bisset GS III, Kirks DR. Intussusception in infants and children: diagnosis and therapy. Radiology. Jul 1988;168(1):141-5. [Medline].

  4. Bruce J, Huh YS, Cooney DR, et al. Intussusception: evolution of current management. J Pediatr Gastroenterol Nutr. Sep-Oct 1987;6(5):663-74. [Medline].

  5. Conners GP, Weber CE, Emmens RW. Intussusception following a baby walker injury. J Emerg Med. Mar-Apr 1999;17(2):269-71. [Medline].

  6. Ein SH. Recurrent intussusception in children. J Pediatr Surg. Oct 1975;10(5):751-5. [Medline].

  7. Kazez A, Ozel SK, Kocakoc E, Kiris A. Double intussusception in a child: the triple-circle sign. J Ultrasound Med. Dec 2004;23(12):1659-61. [Medline].

  8. Liu KW, MacCarthy J, Guiney EJ, Fitzgerald RJ. Intussusception--current trends in management. Arch Dis Child. Jan 1986;61(1):75-7. [Medline].

  9. Losek JD, Fiete RL. Intussusception and the diagnostic value of testing stool for occult blood. Am J Emerg Med. Jan 1991;9(1):1-3. [Medline].

  10. Luks FI, Yazbeck S, Perreault G, Desjardins JG. Changes in the presentation of intussusception. Am J Emerg Med. Nov 1992;10(6):574-6. [Medline].

  11. Navarro OM, Daneman A, Chae A. Intussusception: the use of delayed, repeated reduction attempts and the management of intussusceptions due to pathologic lead points in pediatric patients. AJR Am J Roentgenol. May 2004;182(5):1169-76. [Medline].

  12. Reijnen JA, Festen C, van Roosmalen RP. Intussusception: factors related to treatment. Arch Dis Child. Aug 1990;65(8):871-3. [Medline].

  13. Sargent MA, Babyn P, Alton DJ. Plain abdominal radiography in suspected intussusception: a reassessment. Pediatr Radiol. 1994;24(1):17-20. [Medline].

  14. Simpson T, Ivey J, Borkowski S. Pediatric management problems. Intussusception. Pediatr Nurs. Jul-Aug 2004;30(4):326-7. [Medline].

  15. Skipper RP, Boeckman CR, Klein RL. Childhood intussusception. Surg Gynecol Obstet. Aug 1990;171(2):151-3. [Medline].

  16. Smith DS, Bonadio WA, Losek JD, et al. The role of abdominal x-rays in the diagnosis and management of intussusception. Pediatr Emerg Care. Dec 1992;8(6):325-7. [Medline].

  17. Vasavada P. Ultrasound evaluation of acute abdominal emergencies in infants and children. Radiol Clin North Am. Mar 2004;42(2):445-56. [Medline].

  18. West KW, Stephens B, Vane DW, Grosfeld JL. Intussusception: current management in infants and children. Surgery. Oct 1987;102(4):704-10. [Medline].

  19. Yamamoto LG, Morita SY, Boychuk RB, et al. Stool appearance in intussusception: assessing the value of the term "currant jelly". Am J Emerg Med. May 1997;15(3):293-8. [Medline].

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Further Reading

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Keywords

intussusception, telescoping of the bowel, prolapse of the bowel, intussusceptum, intussuscipiens, red currant jelly stool, upper respiratory illness, diarrheal illness, Henoch-Schönlein purpura, cystic fibrosis, Meckel diverticulum, intestinal polyp, intestinal lymphosarcoma, intestinal hematomas, mesenteric hematomas, hemangioma, treatment, diagnosis

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Contributor Information and Disclosures

Author

Lonnie King, MD, Consulting Staff, Department of Emergency Medicine, Children's Healthcare of Atlanta at Scottish Rite
Lonnie King, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

Garry Wilkes, MBBS, FACEM, Director of Emergency Medicine, Bunbury Hospital, Western Australia; Medical Director, St John Ambulance, WA Ambulance Service; Adjunct Associate Professor, Edith Cowan University; Clinical Associate Professor, Rural Clinical School, University of Western Australia, Australia.
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Grace M Young, MD, Associate Professor, Department of Pediatrics, University of Maryland Medical Center
Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Richard G Bachur, MD, Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston
Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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