Intussusception for Certified Emergency Nursing (CEN)

Intussusception

Definition/Etiology:

• Bowel segment telescopes into an adjacent bowel segment
• More common in pediatric patients but can also happen in adults!
• Kids = Infections, anatomical factors, idiopathic. Most common under 18 months of age
• Adults = Mass, post-surgical adhesions, G/J tube

Pathophysiology:

• Bowel segment slides in on itself which can disrupt blood flow, causes necrosis and/or sepsis.
• With the diminished blood supply, tissue in the intestines dies. This may progress to a perforation, which is a common cause of peritonitis

Clinical Presentation:

• Abdominal Pain- (kids and babies may draw their knees up)
• N/V
• Bloody stool – RED CURRANT JELLY
• *SAUSAGE SHAPED MASS* (upon visualization or palpation)
• Bloating

Collaborative Management:

• Abdominal CTAbdominal US (usually used more in pediatric
  patients)
• Abdominal X-ray
• Labs
• NPO status
• Surgical intervention for adults
• Enema in children/surgery if ineffective
• Pain management
• Antiemetic
• Fluids

Evaluation | Patient Monitoring | Education:

• Treatment is effective when adults are in the OR and children’s symptoms have resolved with no interception present on the US.
• Children have about a 10% recurrence rate in the first 24 hours.

Linchpins: (Key Points)

• Most common in children <18 months old
• Children get enemas/adults get surgery
• Red currant jelly stool
• Sausage shaped mass