Nursing Practice Case study Intussusception

Intussusception is defined as: “invagination or telescoping of proximal loop of intestine (intussusceptum) into a distal segment (intussuscipiens) and leads to bowel obstruction” (Rogers and Robb, 2010). This leads to impaired venous return, incarceration and finally necrosis of the trapped segment (Nylund et al, 2010). It is the most common surgical emergency in infants and young children. Patients may present with the classic triad of symptoms – abdominal pain, vomiting and blood in stools – although 75% of children present with only two symptoms (Paul et al, 2010). Intussusception has a male preponderance (four males to every one female) and is most common in children under two years of age, with a peak incidence between four to nine months (Paul et al, 2010). Aetiology remains idiopathic in younger children and may be preceded by a viral upper respiratory tract infection or gastroenteritis-like illness (Rogers and Robb, 2010). Bacterial enteritis has been identified as a significant risk factor for developing intussusception (Nylund et al, 2010). Intussusception most often occurs in the ileocolic region (80% of cases) but can appear in any part of the intestine (Rogers and Robb, 2010). Ultrasound is usually used to diagnose the condition, and treatment by radiological reduction (air or contrast enema) is successful in most cases (Paul et al, 2010).