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Ria Rumondang Bulan

Fadil Ahmad

Supervisor : dr. Dian Adi S., Sp.BA

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One of the most common cause of bowelobstruction in infants and toddlers.

First described in 1674 by Paul Barbette;

defined by Treves (1899) as prolapse of onepart of the intestines into the lumen of theimmediately adjoining part.

First successful operation for intussuceptionperformed by John Hutchinson in 1873.

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Derived from Latin words intus (within) andsuscipere (to receive)

Is the invagination of one part of the intestine

into another Involving three cylinders of intestinal wall:

a) Inner and middle cylinders are invaginated

bowel (intussuceptum)b) Outer cylinder is the recipients of the

invaginated bowel (intussuscipiens)

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Occurs in approximately 1 in2000 infants and childrenIncidence: 1.5 to 4 per 1000live birthsMale to female ratio is 2:1 or

3:2Occurs more often in whitechildren

75% occurs within the first 2year of life and more than 40%are seen between 3 and 9months of ageFamily history-related

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No identifiableetiology

Often preceded by aviral illness

(Adenovirus andRotavirus ) such asgastroenteritis thatcontribute to the

hypertrophy ofPeyers patches inileum

Common pathologicallead points

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Intussusception can be categorized into fourtypes: general, specific, anatomic, and other

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Classic presentation : intermittent & crampyabdominal pain associated with currant jellystools and palpable mass on physical

examination (sausage-shaped mass/bananasign)

Worsen obstructive and bowel ischemiadevelop dehydration, fever, tachycardia, and

hypotension

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History : 15-30 mins interval of abdominal colic(drawing up legs and crying ), quite episode,vomiting, streaks of blood in stools

Physical examination : abdominal distentionsausage-shaped mass, currant jelly stools,febrile

Radiology

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Plain abdominal film(only 45% accuracy) :soft tissue shadow in

the right upperquadrant, paucity ofgas in the right lowerquadrant. Air fluid

level, dilated bowelloops

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Ultrasonography (up to 100% accuracy) : targetsign/doughnut sign, pseudokidney sign

target

sign

pseudokidney

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Radiologic

Perforation

Surgical

Wound infectionWound

dehiscence

Evisceration

Adhesive smallbowel obstruction

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