الفهرس 
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Abstract
SUMMARY AND RECOMMENDATIIONS
Intussusception refers to the invagination of a part of the
intestine into itself. It is the most common cause of
intestinal obstruction in infants between 6 and 36 months
of age.
Approximately 75 percent of cases of intussusception are
considered ”idiopathic”, although some of these episodes
may be triggered by viral infections. The remaining 25
percent of cases are caused by an underlying disease or
condition which creates a pathological lead point for the
intussusception, including Meckel diverticulum.
Intussusception typically presents with the sudden onset
of intermittent, severe, crampy, progressive abdominal
pain, sometimes with vomiting and grossly bloody stools.
In a minority of cases, the initial presenting sign may be
lethargy or altered consciousness alone, without apparent
abdominal symptoms.
Ultrasonography is the method of choice to detect
intussusception in most institutions. A ”bull’s eye” or
”coiled spring” lesion is seen, representing layers of the
intestine within the intestine.
Summary
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For stable patients with radiographic evidence of
intussusception and no evidence of bowel perforation,
recommend nonoperative reduction of the intussusception
rather than surgery or observation). The reduction can be
guided by fluoroscopy or ultrasound, and either
hydrostatic or pneumatic enemas may be used. The
success rates and risks of these techniques are similar;
ultrasound-guided approaches have the benefit of better
identification of pathological lead points and lower
exposure to radiation.
Intussusception recurs after successful nonoperative
reduction in approximately 10 percent of patients. If the
patient is stable, suggest treating recurrences with
repeated nonoperative reduction rather than surgery.
Patients with one or more recurrences are more likely to
have pathological lead points.
Surgical treatment is indicated as a primary intervention
for patients with suspected intussusception who are
acutely ill or have evidence of perforation. Surgery also
may be appropriate when the patient is treated in a
location where the radiographic facilities and expertise to
perform nonoperative reduction are not readily available.
Surgery also may be necessary for patients in whom
nonoperative reduction is unsuccessful, or for evaluation
or resection of a pathological lead point