Unique Considerations in the Neonate and Infant: Intussusception

Intussusception occurs where there is invagination of bowel into its neighboring distal segment (Fig. 28.1a and b) As bowel invagination progresses, its mesentery becomes incorporated and venous outflow is obstructed. Engorgement and swelling of the bowel follows which obstructs the arterial supply with ischemia leading to necrosis. The etiology of this invagination is thought to be due to hyperplastic intestinal Peyer’s patches which act as a lead point. In many cases this hyperplasia occurs secondary to viral infection, typically following an upper respiratory tract infection o r gastroenteritis.