Intussusception physical examination: Difference between revisions

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{{Intussusception}}
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==Overview==
==Overview==
==Physical Examination==
Patients with intussusception usually appear in distress . [[Physical examination]] of patients with intussusception is usually remarkable for [[Dance's sign]], sausage shaped palpable mass, and [[abdominal distension]]. On [[rectal examination]] the intussusceptum might be felt. Classical sign of intussusception is currant jelly stools, and may present in a minority of cases at a later stage of the disease. Patient with intussusception usually appear chubby and there may be [[loss of appetite]].   
===Vital Signs===
 
* [[Shock]] may be present
==Physical Examination ==
The presence of following findings on [[physical examination]] is highly suggestive of intussusception.
* [[Dance's sign]] - Scaphoid (empty) right lower [[abdomen]].<ref name="pmid7438637">{{cite journal |vauthors=Sty JR, Babbitt DP, Boedecker RA |title=Radionuclide "Dance Sign." |journal=Clin Nucl Med |volume=5 |issue=11 |pages=502–3 |year=1980 |pmid=7438637 |doi= |url=}}</ref>
* "Sausage Shaped" palpable mass in the right mid or lower [[abdomen]].
** This is hard to [[palpate]]. It is best palpated between episodes of [[Spasms|spasm]] especially when the [[infant]] is quiet.
* [[Abdominal distension|Abdominal distention]] is seen when [[intestinal obstruction]] is complete.
* Rigidity and involuntary [[Abdominal guarding|guarding]] (suggests [[peritonitis]] secondary to [[intestinal]] [[gangrene]] and [[infarction]])
Other features
* Episodic [[lethargy]] or [[Altered sensorium|altered consciousness]], alternating with crying spells 
 
* Episode lasts 15 to 30 mins
 
===Appearance of the patient===
*Patient with intussusception are usually chubby and healthy.
*Intussusception is uncommon in [[malnourished]] patients. 
*Patients with intussusception usually appear in distress.
 
===Vital signs===
 
*[[Hypotensive]] if in [[Shock (medical)|shock]]
*[[Fever]] and [[leukocytosis]] indicate transmural [[gangrene]] and [[infarction]] (late signs)
 
===Skin===
* [[Pallor]] - [[Infant]] can be [[Pale skin|pale]] and [[diaphoretic]]
 
===Abdomen===
===Abdomen===
* A mass may be present
*[[Dance's sign]] - [[Scaphoid]] (empty) right lower [[abdomen]].
===Other===
*"Sausage Shaped" palpable mass in the right mid or lower [[abdomen]].
* [[Dehydration]] may be present
** This is hard to [[palpate]]. It is best [[Palpation|palpated]] between episodes of [[Spasms|spasm]] especially when the [[infant]] is quiet.
*[[Abdominal distention]] :- seen when intestinal obstruction is complete.
*A palpable [[abdominal mass]] in the right/left upper/lower [[abdominal]] quadrant
*[[Hematochezia]] and currant jelly stools (classic sign)<ref name="pmid15729613">{{cite journal |vauthors=Toso C, Erne M, Lenzlinger PM, Schmid JF, Büchel H, Melcher G, Morel P |title=Intussusception as a cause of bowel obstruction in adults |journal=Swiss Med Wkly |volume=135 |issue=5-6 |pages=87–90 |year=2005 |pmid=15729613 |doi=2005/05/smw-10693 |url=}}</ref><ref name="pmid9148991">{{cite journal |vauthors=Yamamoto LG, Morita SY, Boychuk RB, Inaba AS, Rosen LM, Yee LL, Young LL |title=Stool appearance in intussusception: assessing the value of the term "currant jelly" |journal=Am J Emerg Med |volume=15 |issue=3 |pages=293–8 |year=1997 |pmid=9148991 |doi= |url=}}</ref><ref name="pmid8253498">{{cite journal |vauthors=Mehta MH, Patel RV, Gondalia JS |title=Intraperitoneal red currant jelly in intussusception |journal=Indian J Pediatr |volume=60 |issue=3 |pages=455–7 |year=1993 |pmid=8253498 |doi= |url=}}</ref>
*[[Abdominal guarding|Guarding]] -  Rigidity and involuntary [[Abdominal guarding|guarding]] (suggests [[peritonitis]] secondary to [[intestinal]] [[gangrene]] and [[infarction]])
 
=== Rectal examination ===
* Intussusceptum may be felt by the finger
 
==References==
{{reflist|2}}
 
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Needs content]]
 
{{WS}}
{{WH}}

Latest revision as of 16:20, 9 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sargun Singh Walia M.B.B.S.[2]

Overview

Patients with intussusception usually appear in distress . Physical examination of patients with intussusception is usually remarkable for Dance's sign, sausage shaped palpable mass, and abdominal distension. On rectal examination the intussusceptum might be felt. Classical sign of intussusception is currant jelly stools, and may present in a minority of cases at a later stage of the disease. Patient with intussusception usually appear chubby and there may be loss of appetite.

Physical Examination

The presence of following findings on physical examination is highly suggestive of intussusception.

Other features

  • Episode lasts 15 to 30 mins

Appearance of the patient

  • Patient with intussusception are usually chubby and healthy.
  • Intussusception is uncommon in malnourished patients.
  • Patients with intussusception usually appear in distress.

Vital signs

Skin

Abdomen

Rectal examination

  • Intussusceptum may be felt by the finger

References

  1. ↑ Sty JR, Babbitt DP, Boedecker RA (1980). "Radionuclide "Dance Sign."". Clin Nucl Med. 5 (11): 502–3. PMID 7438637.
  2. ↑ Toso C, Erne M, Lenzlinger PM, Schmid JF, Büchel H, Melcher G, Morel P (2005). "Intussusception as a cause of bowel obstruction in adults". Swiss Med Wkly. 135 (5–6): 87–90. doi:2005/05/smw-10693 Check |doi= value (help). PMID 15729613.
  3. ↑ Yamamoto LG, Morita SY, Boychuk RB, Inaba AS, Rosen LM, Yee LL, Young LL (1997). "Stool appearance in intussusception: assessing the value of the term "currant jelly"". Am J Emerg Med. 15 (3): 293–8. PMID 9148991.
  4. ↑ Mehta MH, Patel RV, Gondalia JS (1993). "Intraperitoneal red currant jelly in intussusception". Indian J Pediatr. 60 (3): 455–7. PMID 8253498.

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