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Dolor e irritabilidad en la intususcepción pediátrica íleo-cólica y del intestino delgado: Un estudio comparativo
Yarden Shlomovitz1, Rebecca Brooks2, David Rekhtman3
1Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
The American journal of emergency medicine
|February 20, 2026
Resumen
El diagnóstico de la intususcepción pediátrica puede ser un desafío. Si bien la irritabilidad fue más común en la intususcepción del intestino delgado (SMBI), ni el dolor ni la irritabilidad distinguieron de manera confiable la SMBI de la intususcepción íleo-cólica (ILIC).
Área de la Ciencia:
- Medicina de Emergencia Pediátrica
- Gastroenterología
- Diagnóstico por Imagen
Sus antecedentes:
- La intususcepción íleo-cólica (ILIC) es una emergencia pediátrica.
- La intususcepción del intestino delgado (SMBI) puede imitar clínicamente la ILIC.
- La ecografía es clave para diferenciar la ILIC de la SMBI.
Objetivo del estudio:
- Comparar el dolor y la irritabilidad en niños con ILIC frente a SMBI.
- Identificar indicadores clínicos para diferenciar los tipos de intususcepción.
- Evaluar la utilidad diagnóstica de las puntuaciones de dolor e irritabilidad.
Principales métodos:
- Estudio de cohorte retrospectivo de niños de 4 meses a 4 años.
- Se incluyeron pacientes diagnosticados con ILIC o SMBI.
- Se evaluó el dolor utilizando la escala FLACC y la irritabilidad mediante informes de cuidadores/personal.
- Se utilizó regresión multivariable para analizar los resultados.
Principales resultados:
- 141 pacientes incluidos: 84 (59,6%) ILIC, 57 (40,4%) SMBI.
- El dolor en el triaje fue comparable entre ILIC (37,0%) y SMBI (35,1%).
- La irritabilidad fue significativamente más común en SMBI (aOR 7,9).
- La letargia fue más frecuente en ILIC; las tasas de vómitos fueron similares.
Conclusiones:
- El dolor en el triaje es leve y similar tanto para ILIC como para SMBI.
- La irritabilidad es más prevalente en SMBI pero no es un diferenciador confiable.
- Ni el dolor ni la irritabilidad distinguen de manera confiable entre ILIC y SMBI.
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