Invagination intestinale aiguë du nourrisson et de l’enfant

Abstract

Acute intestinal intussusception (AII) in infants and children is defined by the invagination of a portion of the intestine into itself. The consequence is an intestinal obstruction with venous compression and oedema leading to intestinal necrosis. AII constitutes therefore an emergency case. There are 2 kinds of AII: the idiopathic AII in infants that represents 90 to 95% of the cases; the AII that is secondary to a localized lesion (Meckel’s diverticulum, polyp…) or occurring in a digestive disease (Henoch-Schönlein purpura, cystic fibrosis…) or in special circumstances (postoperative AII). Abdominal ultrasound is the key imaging procedure that allows diagnosing AII in infants with acute abdominal pain and vomiting. Non operative reduction by pneumatic or hydrostatic techniques is the first-line treatment, if there is no contra-indication, with a success rate observed to be 80 to 90%. Surgical treatment is a secondary procedure performed in case of failure of non operative reduction or in specific circumstances. The prognosis of AII is excellent, conditioned by a close collaboration between paediatricians, surgeons, radiologists and anaesthesiologists.