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Intussusception is the telescoping or prolapse of one portion of the bowel into an immediately adjacent segment.
- age: 3 months to 6 years, most common among 3-12 months (although case reports exist in adults)
- after constipation, most common cause of abdominal pain in infants and pre-school aged children
- classic triad: colicky abdominal pain, vomiting, and red currant jelly stools
- occurs in only 10% -20% of cases
- although colicky pain is the most common symptom, 15-20% experience no pain
- vomiting is often the earliest symptom, but may be absent in 30-40% cases
- most patients (75%) without grossly bloody stool, may be positive for occult blood
- plain abdominal radiographs may be normal in 30% of cases
- consider in differential for intants with altered mental status/ lethargy
- TIPS AEIOU - one of the "I"s is for intussusception
- choice of radiographic evaluation is institution-dependent
- ultrasound may be diagnostic but is not therapeutic
- air or contrast enema can diagnose and treat
- both are operator dependent