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Gastrointestinal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
6.15. Intussusception in childhood ismost common in infants aged 6-9 months.a self-limited condition.more common in fat babies.generally associated with an umbilical hernia.a recognized complication of Henoch-Schönlein purpura.
Pediatric Imaging in General Radiography
Published in Christopher M. Hayre, William A. S. Cox, General Radiography, 2020
Allen Corrall, Joanna Fairhurst
This is when the intestine telescopes in on itself. This is a serious condition and if undetected or untreated can cause the affected part of the bowel to die and can be further complicated by perforation, leading to sepsis and in the worst case scenario the death of the infant. Fast intervention is critical to maximize the chances of successfully reducing the intussusception with no further complications and full recovery. An ultrasound scan is performed to confirm the diagnosis, and if there is no evidence of perforation or peritonitis a reduction can be performed by an air or contrast enema done under fluoroscopic guidance. If this fails or there are contraindications to the procedure the infant is taken immediately to theatre to undergo a surgical reduction.
Adult Intussusception
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Raphael Parrado, David M. Notrica
Intussusception is defined as the telescoping or invagination of one segment of bowel into an adjacent segment. It was first described by Paul Barbette in 1674 as an intussusceptum telescoping into an intussuscipiens. Later in 1789, John Hunter described a series of three patients using the term “intussusception,” and in 1871, Sir Jonathan Hutchinson first described reduction as a successful treatment in a child.
Ultrasound-guided hydrostatic reduction of ileo-colic intussusception in childhood: first-line management for both primary and recurrent cases
Published in Acta Chirurgica Belgica, 2022
Berat Dilek Demirel, Sertac Hancıoğlu, Basak Dağdemir, Meltem Ceyhan Bilgici, Beytullah Yagiz, Ünal Bıçakcı, Ferit Bernay, Ender Arıtürk
Although intussusception is much more common in infants, may be encountered at any age. The age of the patient should not be regarded as a sole contraindication for hydrostatic reduction [7]. We have been able to perform successful reduction in patients as old as 7 years. Although the success rate of hydrostatic reduction decreases with increasing age, an attempt can be performed with close monitoring but without pushing the limits depending on the conditions of the patient [12]. Although an underlying etiological factor cannot be determined in most of the cases, mass lesions like Meckel’s diverticulum, lymphoma, intra-mural hematoma or enlarged mesenteric lymph nodes may be found, especially in older children [15]. We could be able to identify an LP in 37 of our 108 patients either by US imaging or surgical exploration (34%) and 31 (29%) were mesenteric enlarged lymph nodes. Anatomical anomalies and even malignancy can present with intussusception, they appear to be related with hydrostatic reduction failure [2,7]. In our study, 42% of patients with failed hydrostatic reduction had an anatomical anomaly or malignancy which warrants careful evaluation and awareness during surgical exploration. Another controversial issue is that whether the infectious conditions should be considered as a cause of intussusception in childhood or not, as they may cause hypertrophy of mesenteric lymph nodes which may lead to intussusception [16]. In adults, LP is more common than in children and exclusion of an underlying cause is recommended in adults with intussusception [17].
Gastroduodenal Intussusception Due to Gastric Mucosal Prolapse Polyp in a 2-Year-Old Child
Published in Fetal and Pediatric Pathology, 2021
Mostafa Kotb, Marwa Abdelaziz, Yasmine Abdelmeguid, Ahmed Hassan, Nagwa Mashali, Yasser Saad-Eldin
Intussusception is a condition in which a segment of the intestine invaginates into the lumen of the adjacent bowel, predisposing to intestinal obstruction in most cases. Intussusception may occur at any site in the gastrointestinal tract with ileocolic being the most common location [1]. Gastroduodenal intussusception (also called ball valve syndrome) however, is an unusual type of intussusception that is known to occur in about 10% of intussusception in adults with few cases described in children [2]. It is usually secondary to a single lead point. Various gastric lesions, whether benign or malignant, and previous gastric operations are the predisposing factors of such a condition [3]. We report a unique case of an operatively proven gastroduodenal intussusception due to a cauliflower mass that turned out to be a gastric mucosal prolapse polyp of the pyloric antrum on histopathological assessment.
Colonoscopic diagnosis and reduction of recurrent intussusception owing to Henoch–Schönlein purpura without purpura
Published in Paediatrics and International Child Health, 2019
Teruyoshi Shimoyama, Nozomi Matsuda, Masashi Kurobe, Takehiko Hayakawa, Masato Nishioka, Masayuki Shimohira, Kei Takasawa
In general, intussusception requires emergency medical care and urgent treatment with contrast or air enema reduction. However, therapeutic reduction of the intussusception owing to HSP by using contrast or air enema may not be recommended because of its frequent occurrence in the small bowel and the associated high risk of perforation [15]. Surgical intervention is required in cases with irreducible intussusception by air or contrast enema, ileoileal-type intussusception or intestinal perforation [4,15,19]. It is also important to note that certain cases of HSP without purpura may mimic acute appendicitis, sometimes leading to an unnecessary laparotomy or appendicectomy [20]. Recently, laparoscopy was reported to be a safe and effective diagnostic and therapeutic option for surgical intervention of intussusception with HSP [21]. Our experience suggests that colonoscopy is less invasive and is useful in the diagnosis and reduction of intussusception, as well as histopathological diagnosis in cases without purpura.