Intussusception Differential Diagnoses

  • Author: Felix C Blanco, MD; Chief Editor: Carmen Cuffari, MD   more...
 
Updated: Jan 13, 2012
 
 

Diagnostic Considerations

In rare circumstances, intussusception presents with prolapse of the intussusceptum through the anus. Such prolapse can be confused with rectal prolapse. Careful examination can differentiate between the 2 presentations, as follows:

  • The anal crypts are everted with rectal prolapse and not with intussusception
  • An examining finger can be passed between the prolapse and the anus in patients with intussusception but not in patients with rectal prolapse

Conditions to consider in the differential diagnosis of intussusception, along with those in the next section, include the following:

  • Milk allergy
  • Incarcerated hernia
  • Internal hernia
  • Other, rare causes of intestinal obstruction
  • Adhesive band
  • Volvulus
  • Meckel diverticulum
  • Any process causing abdominal pain or GI bleeding

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Felix C Blanco, MD  Research Fellow, Department of Surgery, Children's National Medical Center

Felix C Blanco, MD is a member of the following medical societies: American College of Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

A Alfred Chahine, MD  Associate Professor of Surgery and Pediatrics, George Washington University School of Medicine and Health Sciences; Chief of Pediatric Surgery, Georgetown University Medical Center; Attending Surgeon, Children's National Medical Center

A Alfred Chahine, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Pediatric Surgical Association, and International Pediatric Endosurgery Group

Disclosure: Nothing to disclose.

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.

Garry Wilkes  MBBS, FACEM, Director of Emergency Medicine, Calvary Hospital, Canberra, ACT; Adjunct Associate Professor, Edith Cowan University; Clinical Associate Professor, Rural Clinical School, University of Western Australia

Disclosure: Nothing to disclose.

Specialty Editor Board

Hisham Nazer, MB, BCh, FRCP, DCh, DTM&H  Professor of Pediatrics, Consultant in Pediatric Gastroenterology, Hepatology and Clinical Nutrition, Bushnaq Medical Centre, University of Jordan Faculty of Medicine, Jordan

Hisham Nazer, MB, BCh, FRCP, DCh, DTM&H is a member of the following medical societies: Royal College of Paediatrics and Child Health, Royal College of Physicians, Royal College of Surgeons in Ireland, Royal College of Surgeons of Edinburgh, and Royal Society of Tropical Medicine and Hygiene

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

B UK Li, MD  Professor of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Director, Pediatric Fellowships and Gastroenterology Fellowship, Medical Director, Functional Gastrointestinal Disorders and Cyclic Vomiting Program, Medical College of Wisconsin; Attending Gastroenterologist, Children's Hospital of Wisconsin

B UK Li, MD is a member of the following medical societies: Alpha Omega Alpha, American Gastroenterological Association, and North American Society for Pediatric Gastroenterology and Nutrition

Disclosure: Nothing to disclose.

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.

Chief Editor

Carmen Cuffari, MD  Associate Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University School of Medicine

Carmen Cuffari, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

References

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  17. Shekherdimian S, Lee SL, Sydorak RM, Applebaum H. Contrast enema for pediatric intussusception: is reflux into the terminal ileum necessary for complete reduction?. J Pediatr Surg. Jan 2009;44(1):247-9; discussion 249-50. [Medline].

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Abdominal radiograph shows small bowel dilatation and paucity of gas in the right lower and upper quadrants.
Air contrast enema shows intussusception in the cecum.
Barium enema shows intussusception in the descending colon.
CT scan reveals the classic ying-yang sign of an intussusceptum inside an intussuscipiens.
Abdominal ultrasonography reveals the classic target sign of an intussusceptum inside an intussuscipiens.
Laparoscopic view of a jejuno-jejunal intussusception
Note intussusception in the left upper quadrant on this plain film of an infant with pain vomiting. Courtesy of Dr. Kelly Marshall, Children's Healthcare of Atlanta at Scottish Rite.
Intussusception evident during air contrast enema prior to reduction. Courtesy of Dr. Kelly Marshall, Children's Healthcare of Atlanta at Scottish Rite.
 
 
 
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