PEDIATRICSCOMPLICATIONS
■ Intestinal perforation
■ Infants who recover from NEC may have bowel strictures, and postopera-
tively may develop short gut syndrome.
INTUSSUSCEPTION
■ Occurs when a proximal portion of bowel telescopes into a more distal
portion, typically with the ileum inserting through the ileocecal valve
■ Most common cause of bowel obstruction in infants between the ages of
3 and 12 months
■ Peak incidence of intussusception is between the ages of 5 and 9 months,
although intussusception may occur anytime from birth through childhood.
In children >2 years old, an abnormal lead point such as a tumor, Meckel’s
diverticulum, or polyp is much more likely.
■ Males are affected more frequently than females.
SYMPTOMS
Classic triad:
■ 85%, colicky abdominal pain
■ 75%, vomiting
■ 40%, rectal bleeding (“currant jelly stools”is a late finding due to slough-
ing of the bowel mucosa). Most cases of intussusception are diagnosed
prior to bowel necrosis.
FIGURE 5.17. Necrotizing enterocolitis.
(Reproduced, with permission, from Brunicardi FC et al (eds). Schwartz’s Principles of Surgery,
8th ed. New York: McGraw-Hill, 2005:1493.)
Currant jelly stools is a late
finding of intussusception