Overview
Ileocolic intussusception involves the telescoping of one segment of the intestine into an adjacent segment, typically causing bowel obstruction in young children 1.Diagnosis
Clinical presentation includes abdominal pain, vomiting, and bloody stools (currant jelly stools) 1.
Imaging studies, particularly ultrasound, are crucial for diagnosis, often showing a "pseudo-kidney" sign 1.
Contrast enema may also be used for both diagnosis and treatment 1.Management
First-line treatment: Non-surgical reduction methods, primarily pneumatic reduction (air enema) 1.
Sedation for pneumatic reduction: In certain cases, sedation with agents like ketamine, propofol, or midazolam can be administered by emergency physicians to facilitate the procedure, with successful outcomes reported 1.Special Populations
Pediatrics: Sedation protocols for pneumatic reduction appear safe and effective in infants and young children 1.Key Recommendations
Pneumatic reduction is effective and recommended as the first-line non-surgical treatment for ileocolic intussusception in children 1 (Evidence: Strong).
Sedation with appropriate agents such as ketamine, propofol, or midazolam can be safely administered by trained emergency physicians to facilitate pneumatic reduction 1 (Evidence: Moderate).
Ultrasound should be the primary imaging modality for diagnosing ileocolic intussusception 1 (Evidence: Strong).References
1 Shavit I, Shavit D, Feldman O, Samuel N, Ilivitzki A, Cohen DM. Emergency Physician-Administered Sedation for Pneumatic Reduction of Ileocolic Intussusception in Children: A Case Series. The Journal of emergency medicine 2019. link