ENCLOSURE
An intussusception is the sliding of a segment of the intestine into the distal segment of the intestine.
Idiopathic intussusception is common in childhood and occurs between the 6th and 18th months of life and only in 15% of cases after the 3rd year of life.
No etiological factor has been identified, but a possible factor is hyperplasia of the lymphoid tissue plaques. A specific etiological factor is found in 5% of cases. In older ages, the cause is Meckel’s diverticulum, possible polyps and lymphosarcoma.
Of particular importance for both parents and pediatricians is not so much the etiology as the clinical picture. Initially, we have acute colicky intermittent abdominal pain, which in infancy is characterized by persistent crying and particular anxiety. During the episodes, the infant cries loudly, bends the knees and may also vomit. The late symptoms are fever, malaise, pallor, a sick body image and stools the color of gooseberry jelly, which is a diagnostic criterion.
Palpation of the abdomen helps in the diagnosis, while barium enema acts both diagnostically (confirmation of diagnosis) and therapeutically (reduction of intussusception in 60 -70% of cases).
The differential diagnosis of intussusception is gastroesophageal reflux disease, mesenteric lymphadenitis due to yersinia, intestinal obstruction, inflammatory bowel disease, urolithiasis, cholelithiasis and irritable bowel syndrome, appendicitis, etc.
Surgical evaluation is necessary and surgical reduction is performed when there are signs of peritonitis or shock, when reduction with barium enema fails or when there is a possibility of finding the causative agent.
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