Ileocolic Intussusception, Suspected — Child with Suspected Ileocolic Intussusception — Clinical Pathway: Emergency Department

Suspected Ileocolic Intussusception Clinical Pathway — Emergency Department

Child with Suspected Ileocolic Intussusception

Ileocolic intussusception without pathologic lead point is commonly seen in healthy children aged 6 months to 3 years old. For children outside of this age range, review need for further evaluation to identify a pathologic lead point.

KOPH

Patients at KOPH are transferred to PHL Campus for reduction procedure.
KOPH Transfer Guidelines

Exclusion Criteria

  • Small bowel intussusception
  • Peritonitis
  • Recent abdominal/bowel surgery

Small Bowel Intussusception

  • Generally, a benign process
  • Often found incidentally, associated with conditions that cause bowel inflammation and hypermotility (e.g., gastroenteritis, HSP)
  • Management differs from ileocolic intussusception as small bowel intussusception is less likely to respond to nonoperative reduction and more likely to reduce spontaneously, provided that the intussusceptum is short and is isolated to the small bowel.
  • Further work-up, treatment or observation/admission rarely required unless long segment involved, severe pain or child unable to maintain hydration.
  • In one series of patients with isolated small bowel intussusception, all cases in which the intussusceptum was < 3.5 cm resolved spontaneously, children who required surgery had a mean intussusceptum length of 7.3 cm (95% CI 4.8-9.7 cm)

Reference

Sonography of Pediatric Small-bowel Intussusception: Differentiating Surgical from Nonsurgical Cases