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:
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The anal crypts are everted with rectal prolapse and not with intussusception
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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:
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Milk allergy
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Incarcerated hernia
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Internal hernia
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Other, rare causes of intestinal obstruction
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Adhesive band
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Volvulus
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Meckel diverticulum
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Any process causing abdominal pain or GI bleeding
Differential Diagnoses
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Blunt Abdominal Trauma in Emergency Medicine
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Abdominal radiograph shows small bowel dilatation and paucity of gas in the right lower and upper quadrants.
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Air contrast enema shows intussusception in the cecum.
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Barium enema shows intussusception in the descending colon.
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CT scan reveals the classic ying-yang sign of an intussusceptum inside an intussuscipiens.
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Abdominal ultrasonography reveals the classic target sign of an intussusceptum inside an intussuscipiens.
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Laparoscopic view of a jejuno-jejunal intussusception
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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.
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Intussusception evident during air contrast enema prior to reduction. Courtesy of Dr. Kelly Marshall, Children's Healthcare of Atlanta at Scottish Rite.
