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Paediatrics
Published in David A Lisle, Imaging for Students, 2012
Intussusception refers to prolapse or telescoping of a segment of bowel (referred to as the intussusceptum) into the lumen of more distal bowel (the intussuscepiens). The most common form of intussusception is ileocolic, i.e. prolapse of distal small bowel into the colon. Intussusception occurs most commonly in young children, usually from six months to two years of age, with a peak incidence at around nine months. At this age, intussusception is usually regarded as idiopathic, although enlarged lymph nodes secondary to viral infection are thought to be responsible in most cases. In older children, a lead point should be suspected. Causes of a lead point include Meckel diverticulum, mesenteric cyst and lymphoma. (Intussusception may also occur in adults with underlying causes including benign small bowel tumours such as lipoma, Meckel diverticulum and foreign body.) Signs and symptoms of intussusception include vomiting, blood-stained stool, colicky abdominal pain, listlessness and palpable abdomi nal mass. Imaging in suspected intussusception consists of an AXR followed by US.
Maternal smoking as a risk factor for childhood intussusception
Published in Archives of Environmental & Occupational Health, 2018
Yasuo Nakahara, Takashi Yorifuji, Toshihide Kubo, Hiroyuki Doi
Intussusception is the most common cause of intestinal obstruction among infants and young children. The condition develops when a proximal segment of intestine invaginates into a distal segment of intestine, resulting in intestinal obstruction and constriction of the mesentery. The pathogenesis of idiopathic intussusception is not well established, but it has been hypothesized that altered bowel motility or a mass such as enlarged Peyer's patch acting as a lead point induces an imbalance in the longitudinal forces of the intestinal wall and causes intussusception. Reduction is generally accomplished by ultrasonography or fluoroscopically guided enema. If reduction by enema fails, surgical reduction is required. Untreated intussusception eventually leads to bowel necrosis and is potentially fatal. According to one epidemiological study in Japan, annual incidence of intussusception is 170–180 cases per 100,000 children.1