Meckel’s Diverticulum presenting as Intussusception.

Meckel’s Diverticulum presenting as Intussusception.

Telescoping in of a proximal segment of intestine to a distal segment is called Intussusception. The proximal segment is called intussusceptum and the distal segment is called intussuscepiens.

The initiating lesion leading to  Intussusception is called a pathological lead point. A lead point can be a polyp,  submucous lipoma,  stromal tumour or Meckel’s Diverticulum.

The commonest site of Intussusception is Ileo caecal region. The clinical features include abdominal pain, vomiting, distension and passage of Red currant jelly stools.

The basis of Red currant jelly stools is due to the excess mucus production from the intussuscepted intestine which gets mixed with blood from the congested intestine.

On examination of abdomen, emptiness of the right iliac fossa is called signe-de-dance (The Sign of Dance). It is due to the pulled up caecum leading to a palpable sausage shaped mass in the umbilical area.

Ultra sonological sign of Intussusception is called Target sign on end on view and a Pseudo kidney appearance in the longitudinal view. Barium enema appearance of Intussusception is called Claw sign.

Non operative management of Intussusception can be tried with Hydrostatic reduction. Per operatively Intussusception is reduced by milking from the distal or advancing point (apex) and not by pulling from the proximal part.