Apathy as an Early Manifestation of Intussusception

Intussusception is usually a readily diagnosed disease with an easily recognized symptom complex. Many reviews stress the typical clinical spectrum and the value of early diagnosis for successful reduction. 1,2 The atypical cases and the less common manifestations of this serious condition, however, have not always been adequately emphasized and still constitute a diagnostic challenge to the pediatrician and pediatric surgeon. We describe five infants with intussusception whose prominent complaints early in the course of the disease were apathy and listlessness—manifestations formerly considered to be late and ominous signs of this condition. 1,3 Patients .—The patients were 6 to 12 months old, previously healthy, and well developed, and symptoms preceded admission to the hospital by four to 24 hours in all cases. Some degree of altered consciousness was the main symptom, and usually the most threatening one for both parents and physician. All the patients had recurrent vomiting, and