Intussusception

Abstract

Intussusception is a common cause of bowel obstruction in infants and young children. The condition occurs when one segment of the intestine, the intussusceptum, is invaginated into an adjacent segment, the intussuscipiens. In more than 80 % of cases, the distal ileum invaginates into the colon (termed ileocolic intussusception), although involvement of other areas of the bowel is not uncommon, especially in children falling outside the classic age range and in those patients with a pathologic lead point. Although most cases are idiopathic, a pathologic lead point may be identified in 2–12 % of children, the likelihood increasing with age. After age 4 years, lead points are found in over 50 % of patients. In adult cases of intussusception, an identifiable lead point is present in as many as 97 % of cases. Regardless of etiology, as intussusception evolves, the mesentery of the proximal bowel segment is drawn further into the distal segment, resulting in venous obstruction and eventual arterial insufficiency and bowel necrosis if the obstruction is not relieved.