0 Intrusion of a proximal intestinal segment into the more distal intestinal lumen.
It is seen with a frequency of 0 1-4/1000. M/K: 3/1-2. It is common in 5-10 month old babies.
It is the most common cause of intestinal obstruction in infants between 0 3-24 months.
0 It is the most common emergency requiring surgical treatment in children younger than two years of age.
0 It often starts from the terminal ileum and progresses to the colon.
0 It is common in well-nourished obese infants.
0 There is vomiting, abdominal pain, rectal bleeding, lethargy (intussusception encephalopathy).
0 Babies are restless, cry with their feet on their stomach and vomit their stomach contents.
0 There is bloody, mucous stool in the form of "strawberry jelly".
0 Pain comes in attacks.
0 There are signs of dehydration, abdominal distension and mass palpation in the form of sausage.
0 When the normal elements of the lower right quadrant are not in place and this quadrant is empty, it is called the "dance sign".
0 Sometimes the segment of invaginated bowel may prolapse out of the rectum.
0 Abdominal tenderness, fever, tachycardia, tachypnea, leukocytosis; in favor of gangrene, perforation and peritonitis.
0 The cause of death in these children is hypovolemia and sepsis.
Diagnosis
• SDAR has signs of obstruction; gas-liquid level is seen.
• Dance sign; It is the collection of intestinal loops in the middle of the abdomen and the decrease of gas in the right lower quadrant.
• Ultrasound is very helpful in diagnosis, and there are two interlocking rings "ox eye, target mark, false kidney".
• If the ultrasound reduction is successful, a "donut" image will appear.
• Colon X-ray can both establish the definitive diagnosis and provide treatment. There is a goblet appearance on the colon graph.
Treatment
• First, the nasogastric tube is inserted.
• Reduction with air or barium is attempted. Surgical intervention may be required.
• Ascariasis is the most common infectious cause of obstruction requiring surgery in children.