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An Unusual Presentation of Intussusception
Kathryn Dickson1, Ann E Gerhart, K Sue Hoyt
1Emergency Department, Naval Medical Center San Diego, San Diego, California (Ms Gerhart); Emergency Department, Scripps Memorial Hospital La Jolla, California (Dr Dickson); and Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, California (Dr Hoyt).
Abstract:
This is the case of a 9-month-old female infant who presented to the emergency department with a history of several episodes of nonbilious and nonbloody emesis. The patient was found to be afebrile with normal vital signs and an otherwise normal physical examination. Initial plain film radiography was concern for possible obstruction. Imaging studies with ultrasonogram demonstrated intussusception. This was an unusual case of intussusception because children are typically more ill-appearing with vomiting, diarrhea, fevers, lethargy, and blood in stool. Management options included surgery, pneumatic enema reduction, and barium enema reduction. Pneumatic enema reduction was performed. This procedure has been shown to have superior outcomes in infants with intussusception. Advanced practice providers need to provide a detailed history, complete a thorough physical examination, order the appropriate diagnostics, and be vigilant of the clinical manifestation of intussusception.
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