Intussusception

Definition

Intussusception is the telescoping or invagination of one segment of intestine into an adjacent segment, causing bowel obstruction, impaired blood flow, and potential necrosis. It is the most common cause of bowel obstruction in children ages 3 months to 6 years.

Classic Presentation

• Sudden severe colicky abdominal pain; child draws knees to chest
• Vomiting (initially non-bilious, later bilious)
• 'Currant-jelly' stools (blood and mucus). LATE sign
• Sausage-shaped mass in RUQ
• Lethargy between episodes

Diagnosis

Abdominal ultrasound is gold standard (shows 'target' or 'bull's-eye' sign). Contrast enema both diagnostic and often therapeutic.

Nursing Interventions

NPO, IV fluids, NG decompression, preparation for air or hydrostatic enema (success rate 80 to 90%). Surgery for failed reduction, perforation, or recurrent disease. Monitor for recurrence (up to 10%) and notify provider of spontaneous brown stool. Indicates successful reduction.

NCLEX Relevance

Classic triad in pediatrics: pain, vomiting, currant-jelly stools.