Causes |
- Idiopathic (most common)
- Viral infections (e.g., adenovirus, rotavirus)
- Peyer's patch hypertrophy (lymphoid hyperplasia)
- Meckel’s diverticulum
- Intestinal polyps
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- Benign or malignant tumours (commonest cause in adults)
- Intestinal polyps
- Adhesions from prior surgery
- Inflammatory bowel disease (e.g., Crohn’s disease)
- Submucosal lipomas
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Types |
- Ileocolic (most common)
- Enteroenteric
- Colocolic
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- Ileocolic
- Enteroenteric
- Colocolic
- Ileoileal
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Clinical Presentation |
- Sudden onset of colicky abdominal pain
- Currant jelly stool (mucus and blood)
- Vomiting (non-bilious or bilious)
- Pain followed by lethargy (intermittent periods)
- Palpable sausage-shaped mass in abdomen
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- Intermittent abdominal pain
- Weight loss
- Change in bowel habits (e.g., diarrhoea or constipation)
- Lower gastrointestinal bleeding
- Signs of bowel obstruction (nausea, vomiting)
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Diagnostic Tests |
- Ultrasound: Target sign or doughnut sign
- Abdominal X-ray: Air-fluid levels, signs of obstruction
- Contrast enema: Diagnostic and therapeutic (air or barium)
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- CT scan: Best imaging modality in adults, shows target sign
- Abdominal X-ray: Signs of bowel obstruction
- Colonoscopy: To assess for tumours, polyps, or mass lesions
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Management |
- Non-surgical (preferred): Air or barium enema for reduction
- Surgical: Laparotomy if enema fails or signs of perforation or peritonitis
- Supportive care: IV fluids, analgesia, and antibiotics if needed
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- Surgical resection: Commonly required to remove underlying pathology (e.g., tumour)
- Supportive care: IV fluids, analgesia, and antibiotics if signs of infection or peritonitis
- Endoscopic reduction: May be considered in select cases
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Prognosis |
- Good prognosis if treated early
- Delay in treatment can lead to bowel ischaemia, necrosis, or perforation
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- Dependent on the underlying cause (e.g., tumour prognosis)
- Delayed diagnosis can lead to bowel obstruction or perforation
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