• Invagination of bowel into more distal bowel through peristalsis
• 90% idiopathic ileocolic
• 3/12 – 1 year
• Lead point in children > 3 years old
• Signs and symptoms include abdominal pain, redcurrant jelly-like stools, vomiting and a palpable right iliac fossa mass
• Diagnosis is often by ultrasound which demonstrates classic appearances as above.
• Treatment is with air enema or surgery

When using air reduction a maximum of three attempts should be made. Each should be a maximum of 3 minutes in duration. The initial pressure should be 60 to 80 mmHg and the maximum pressure should be 120 mmHg, so three attempts at 80, 100 and 120 mmHg is reasonable. Ideally the paediatric surgical team should be present. If perforation of the bowel occurs, insufflation of air must be stopped immediately and care should be taken to assess for tension pneumoperitoneum (which may require relief with needle decompression).

References:

1. Williams H. Imaging and intussusception. Arch Dis Child Educ Pract Ed. 2008;93(1):30–36.