5.5 G) V) Intussusception

Front 1

What is the most common cause of acute intestinal obstruction in a child 3-12 months of age?

Back 1

Intussusception

Front 2

What is intussusception?

Back 2

invagination of a proximal segment on bowel into the the distal bowel lumen

Front 3

What is the age range of presentation of intussusception?

Back 3

2 months to 2 years.

Front 4

what is the peak age incidence of intussusception?

Back 4

5-9 months

Front 5

What is the classic clinical triad of intussusception?

Back 5

1. intermittent crampy abdominal pain
2. vomiting
3. bloody stools [late sign]

Front 6

which of the following is incorrect regarding intussusception?
1. ileocolic intussusception occurs in 85% cases
2. It is often precede by a viral infection
3. XR findings of the crescentic sign, or target sign are quite common.
4. Air enema - both diagnostic and therapeutic
5. Ultrasound is the diagnostic investigation of choice.

Back 6

3. Definitive radiographic signs are seen infrequently {<50%}

Front 7

The flow chart for Ix and Mx of intussusception includes all of the following except?
1. establish IV access
2. give fluid boluses if shocked / hypovolaemia
3. Arrange Ultrasound if high suspicion of intussusception and no AXR evidence of perforation, bowel obstruction.
4. IV antibiotics are not given for Ultrasound positive intussusception
5. Laparotomy is performed for AXR evidence of perforation.

Back 7

4. IV cefazolin and metronidazole are given prior to air enema.

Front 8

Which of the following is incorrect regarding intussusception?
1. Most children will require fluid resuscitation with 20mL/kg NaCl before radiological investigations.
2. Always give analgesia-preferably morphine
3. pass a NGT if obstruction / perforation present on AXR
4. Diarrhoea is uncommon in intussusception
5. Bile stained vomiting is a late sign.

Back 8

4. diarrhoea is quite common.

Front 9

In regards to the Radiographic findings in Intussusception, which of the following is incorrect ?
A. The Crescent sign is the most specific AXR finding.
B. The Target sign is a ring of invaginated mesenteric fat, which is seen in > 60% cases.
C. A gas less right sided abdomen on AXR is the most common finding, but is not specific.
D. The Crescent sign is found in 70% AXR.

Back 9

D. 30% AXR

A = in 30 %
B = seen in 68% - moderately specific.
C = 74 % cases. -not specific.