In which patients should the diagnosis of intussusception be considered

In which patients should the diagnosis of intussusception be considered? 

• In the classic description of intussusception, a child age 3 months to 3 years presents with the legs intermittently drawn up to the chest while crying, bloody stools, vomiting, and a sausage-shaped abdominal mass.
• Unfortunately, the classic presentation is not common, so a high index of suspicion should be maintained for those children presenting with intermittent colicky abdominal pain and vomiting.
• Some children present with lethargy or a change in mental status. The goal is to diagnose and treat intussusception prior to the evolution of “currant-jelly stools,” an indicator that significant bowel ischemia has occurred. 

Sources

Marin JR, Alpern ER: Abdominal pain in children. Emerg Med Clin North Am 2011;29:401-428.