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Intussusception Resource - Clinical Hub, References, Emergency Department Resources, Emergency Department Pediatric Resources
For children with suspected intussusception
- Order “limited abdominal ultrasound” to confirm the diagnosis.
- For pediatric patients at Meriter, the diagnostic ultrasound can be performed at Meriter, but the patient must be transferred to the UW for treatment.
- If an abdomen series is chosen as the first method of imaging a child with abdominal pain and intussusception is in the differential diagnosis, order supine and left lateral decubitus views (not supine and upright) regardless of child’s ability to ambulate.
For children with diagnosed intussusception
- If diagnosed by CT or plain radiographs, an ultrasound is still required by the radiologist to evaluate for blood flow in the intussusception and interloop fluid prior to reduction. If CT or radiographs were performed at an outside institution, we also want to confirm that the intussusception has not reduced itself during the transfer.
- If diagnosed on outside ultrasound, the attending pediatric radiologist will review the images and determine if another ultrasound is indicated.
Ordering an enema for reduction
- Enema can be performed to reduce intussusception as long as the patient does not have peritonitis/pneumoperitoneum.
- Prior to arrival in fluoroscopy:
- Place order for “ GI Barium enema intussusception reduction”
- Pediatric Surgery Consult must be obtained prior to ordering the enema.
- Patient must have an IV and be on a cardiopulmonary monitor
- Patients should receive a fluid bolus (20 cc/kg NS or LR)
- Patient must be normothermic
- Communicate with radiology regarding timeline for reduction. Once the procedure time is set, notify radiology regarding any significant delay.
- Monday – Friday, 8am-4:30pm: (608) 263-0670, (608) 263-0671
- After hours and on weekends: (608) 263-6461 or pager #0082 to reach the radiology resident on call
- Upon arrival to fluoroscopy:
- A left lateral decubitus radiograph will be obtained to evaluate for pneumoperitoneum which is a contraindication to enema reduction.
- Consent will be obtained by the radiologist