The clinical implications of non-idiopathic intussusception

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Functional Assessment of Intestinal Motility and Gut Wall Inflammation in Rodents: Analyses in a Standardized Model of Intestinal Manipulation
09:44

Functional Assessment of Intestinal Motility and Gut Wall Inflammation in Rodents: Analyses in a Standardized Model of Intestinal Manipulation

Published on: September 11, 2012

R T Blakelock1, S W Beasley

  • 1Department of Paediatric Surgery, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand.

Pediatric Surgery International
|January 9, 1999
PubMed

Insights

A pathological lesion is the cause of intussusception in 6% of cases, increasing with age, especially in children over five. These lesions often prevent enema reduction and may be identified during or after the procedure.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Radiology

Background:

  • Intussusception, a common cause of bowel obstruction, can be idiopathic or associated with a pathological lead point.
  • While clinical features often lack etiological clues, certain conditions like Peutz-Jeghers syndrome may present with characteristic manifestations.
  • Neonatal intussusception may stem from duplication cysts or Meckel's diverticulum, with increasing lesion association beyond 12 months of age.

Purpose of the Study:

  • To investigate the incidence and characteristics of pathological lesions at the lead point of intussusception.
  • To determine the age-related prevalence of identifiable lesions causing intussusception.
  • To explore the implications of pathological lead points on enema reduction and diagnostic imaging.

Main Methods:

  • Review of intussusception cases, analyzing the presence and nature of lead point lesions.
  • Age-stratified analysis of lesion incidence.
  • Correlation of lesion presence with enema reducibility and diagnostic findings (fluoroscopy, ultrasonography).

Main Results:

  • Pathological lesions are identified at the lead point in approximately 6% of intussusception episodes.
  • The proportion of intussusceptions with an identifiable lesion increases significantly with age, particularly in children over five years old.
  • Intussusceptions caused by pathological lead points are typically irreducible by enema and may be visualized during or after reduction via imaging.

Conclusions:

  • A pathological lead point is a significant, age-dependent factor in intussusception etiology.
  • The presence of a lead point lesion impacts treatment options, often contraindicating enema reduction.
  • Diagnostic imaging plays a crucial role in identifying lead point lesions, especially when enema reduction is unsuccessful.

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