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Clinical Findings in Pediatric Postoperative Intussusception

Purpose: To evaluate a child for clinical findings that may suggest a postoperative intussusception.

Description

Postoperative intussusception is an uncommon cause of intestinal obstruction in children after surgery. Certain clinical findings should prompt a rapid assessment of a child in order to prevent bowel necrosis. The authors are from Indiana University and Riley Hospital for Children in Indianapolis.


Time of occurrence - early after surgery (about 50% occur in the first week, 80% within 2 weeks and all within 3 weeks)

 

Most patients are under 3 years of age, but it may occur in older children and adolescents.

 

Surgeries where more common:

(1) antireflux procedures

(2) retroperitoneum surgery

 

Upper GI findings:

(1) bilious gastric drainage

(2) increased nasogastric secretions

(3) vomiting

 

Abdominal findings:

(1) abdominal pain

(2) abdominal distention

(3) palpable abdominal mass

 

Lower GI findings:

(1) diarrhea

(2) rectal bleeding

 

Nonspecific findings:

(1) irritability

(2) flexed knees in an infant

(3) fever

(4) unexplained lethargy

 

Imaging studies will usually demonstrate a bowel obstruction.


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Specialty

Objective

ICD-10