Pediatric Intussusception

Intussusception is the most common cause of bowel obstruction in children 3 months to 3 years of age. It is characterized by invagination of the intestine onto itself leading to obstruction. Ileocolic intussusception is by far the most common type of intussusception in children. It is typically caused by lymphoid hyperplasia. Presentation is characterized by severe intermittent abdominal pain, distension, emesis, and rectal bleeding. Diagnosis is confirmed by ultrasound which demonstrates the pathognomonic target sign of intussuscepted bowel. Reduction of the intussusception can be achieved by enema in stable children without peritoneal findings. Surgical reduction is indicated in children with peritoneal findings or for those who fail enema reduction. Recurrence may occur and can be treated by repeat enema as long as the child remains clinically well without peritoneal findings.