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Unusual cases of intussusception
1Division of Emergency Medicine, University of Mississippi Medical Center, Jackson 39216-4505.
Insights
Intussusception, a common childhood condition, can present atypically, especially in older children. Emergency physicians must consider intussusception in all intestinal obstruction cases to prevent serious complications.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
- Surgical Pediatrics
Background:
- Intussusception is a leading cause of intestinal obstruction in infants and young children.
- Classic symptoms include abdominal pain, vomiting, and bloody stools, but these are often absent in atypical cases.
Observation:
- This study reviews three cases of intussusception presenting outside the typical demographic or with non-classical symptoms.
- Atypical presentations challenge initial diagnosis, particularly in older children or those without the hallmark triad of symptoms.
Findings:
- Intussusception can occur in all age groups and may not present with the classic signs.
- Delayed diagnosis due to atypical symptoms increases the risk of ischemic complications.
Implications:
- Emergency physicians must maintain a high index of suspicion for intussusception in any patient with intestinal obstruction, regardless of age or symptom presentation.
- Early recognition and prompt management are crucial for preventing bowel ischemia and improving patient outcomes.
Abstract:
Intussusception occurs most commonly in the first five years of life and is classically associated with intense intermittent abdominal pain, vomiting, bloody mucoid diarrhea, and a palpable abdominal mass. These cardinal findings are frequently not present, however, particularly outside the usual age range. The emergency physician must therefore be vigilant in considering intussusception as a potential cause for intestinal obstruction in all patients, if ischemic complications are to be avoided. We present three cases of "unusual" intussusception, and provide a review of this entity and a guide to its consideration and work-up in the emergency department.