Intussusception is the invagination of one segment of intestine—the intussusceptum—into another adjacent segment of intestine—the intussuscipiens. Most cases of intussusception are idiopathic, though identifiable causes are increasingly common as patient’s age increases. Identifiable causes are usually intraluminal or intramural anatomic abnormalities that are “picked up” by the bowel mucosa and passed downstream, carrying the attached bowel along with it and thus causing the invagination. In the pediatric population, an anatomic lead point is identified in <10% of cases, whereas in the adult population, a lead point is identified in as many as 97% of cases. When an identifiable lead point is present, patients are less likely to respond to non-operative therapies. The age at which a lead point becomes more common is 4 years, after which lead points are found in over 50% of patients. Among children, the most common anatomic lead point is a Meckel’s diverticulum, followed by polyps of the ileum and colon, hamartomas associated with Peutz-Jeghers syndrome, submucosal hemorrhages associated with Henoch-Schonlein purpura, lymphoma, lymphosarcoma, enteric cysts, inverted appendiceal stumps, and anastomotic suture lines. About half of adult cases of intussusception are due to malignancy.
KeywordsLead Point Gangrenous Bowel Bowel Mucosa Operative Therapy Intermittent Abdominal Pain
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