Intestinal intussusception

Abstract

Intussusception is one of the leading causes of acute abdomen in infants and children younger than 1 year (85 % of cases). The incidence is highest in the first and second year of life, with a peak age between 3 and 9 months. Intussusception is the acquired invagination of one portion of the intestine into the adjacent bowel: the most frequent form is ileocecal. It is usually idiopathic in the first year of age, while in children older than 2 years, a pathologic lead point could be suspected. The characteristic symptomatic triad is represented by intermittent acute colicky abdominal pain, "red currant jelly" or bloody stool, and palpable mass or vomiting. The role of imaging is crucial not only in confirming the clinical hypothesis, in establishing the grade of severity of the disease, and in the differential diagnosis but also in the therapeutic phase through reduction of intussusception. At present ultrasound is the exam of choice because it is easy to perform, it has a high sensibility and specificity in detecting the intussusception, and there is no radio exposition for the young patient and the operator. In the case of the suspect of recent invagination, it is possible to try to resolve the situation with X-ray or ultrasound contrast enema. In our institution, we usually perform ultrasound-guided hydrostatic reduction by contrast enema: it is a valid and safe procedure.