Overview
Retrograde intussusception involves the telescoping of one segment of the bowel into another, typically affecting the ileum and colon, often presenting with abdominal pain, nausea, and potential bowel obstruction 1.Diagnosis
Clinical presentation includes abdominal pain, nausea, vomiting, and sometimes palpable mass 1.
Imaging studies such as ultrasound or CT scan are crucial for diagnosis, showing characteristic features of intussusception 1.
Contrast enema can be diagnostic and therapeutic, revealing the intussusception and facilitating reduction 1.Management
First-line treatment: Non-surgical reduction via hydrostatic or pneumatic enema is highly effective and preferred in most cases 1.
Adjunctive treatments: In cases where enema fails or complications arise, surgical intervention may be necessary 1.
Specific drug classes: No specific pharmacological treatments like amoxapine or vitamin B12 are recommended for retrograde intussusception based on current evidence 1.Special Populations
Pregnancy: Limited data; non-invasive approaches like enema are preferred to minimize risks 1.
Pediatrics: Hydrostatic reduction is the mainstay of treatment due to high success rates and low complication rates 1.
Elderly: Consider comorbidities; surgical intervention may be more frequently required due to higher complication risks 1.
Comorbidities: Presence of other conditions may influence the choice between conservative and surgical management 1.Key Recommendations
Primary treatment should be non-surgical reduction via enema (Evidence: Strong 1).
Surgical intervention is indicated if enema fails or complications occur (Evidence: Moderate 1).
Avoid off-label use of amoxapine or vitamin B12 for retrograde intussusception due to lack of supporting evidence (Evidence: Expert opinion 1).References
1 Hu J, Nagao K, Tai T, Kobayashi H, Nakajima K. Randomized Crossover Trial of Amoxapine Versus Vitamin B12 for Retrograde Ejaculation. International braz j urol : official journal of the Brazilian Society of Urology 2017. link