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Apathy as an Early Manifestation of Intussusception FREE

AVINOAM RACHMEL, MD; YORAM ROSENBACH, MD; JACOB AMIR, MD; GABRIEL DINARI, MD; TOMMY SHOENFELD, MD; MENACHEM NITZAN, MD
Am J Dis Child. 1983;137(7):701-702. doi:10.1001/archpedi.1983.02140330083022.
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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

REFERENCES

Gross RE, Ware PF:  Intussusception in childhood: Experience from 610 cases . N Engl J Med 1948;;239:646-652.
Ravitch MM:  Intussusception , in Ravitch MM, Welch KJ, Randolph JG (eds): Pediatric Surgery . Chicago, Year Book Medical Publishers Inc, 1979;, pp 989-1003.
Ein SH, Stephens CA, Minor A:  The painless intussusception . J Pediatr Surg 1976;;11: 563-564.
Link to Article
Ravitch MM:  Consideration of errors in the diagnosis of intussusception . Am J Dis Child 1952;;84:17-26.
Oberhelman HA, Condon JB:  Symposium on clinical advances in surgery: Acute intussusception in infants and children: Analysis of 95 cases in Cook County Children's Hospital . Surg Clin North Am 1947;;27:3-22.
Thurston DL, Holowach J, McCoy EE:  Acute intussusception: Analysis of 160 cases at St Louis Children's Hospital . Arch Surg 1953;;67: 68-79.
Link to Article
Singer J:  Altered consciousness as an early manifestation of intussusception . Pediatrics 1979;;64:93-95.
Braun P, Germann-Nicod I:  Altered consciousness as a precocious manifestation of intussusception in infants . Z Kinderchir Grenzgeb 1981;;33:307-309.
Eklof O, Hartelivy H:  Reliability of the abdominal plain film in diagnosis of pediatric patients with suspected intussusception . Pediatr Radiol 1980;;9:199-206.
Link to Article
Friedman AP, Haller JO, Schneider M, et al:  Sonographic appearance of intussusception in children . Am J Gastroenterol 1979;;72:92-94.

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References

Gross RE, Ware PF:  Intussusception in childhood: Experience from 610 cases . N Engl J Med 1948;;239:646-652.
Ravitch MM:  Intussusception , in Ravitch MM, Welch KJ, Randolph JG (eds): Pediatric Surgery . Chicago, Year Book Medical Publishers Inc, 1979;, pp 989-1003.
Ein SH, Stephens CA, Minor A:  The painless intussusception . J Pediatr Surg 1976;;11: 563-564.
Link to Article
Ravitch MM:  Consideration of errors in the diagnosis of intussusception . Am J Dis Child 1952;;84:17-26.
Oberhelman HA, Condon JB:  Symposium on clinical advances in surgery: Acute intussusception in infants and children: Analysis of 95 cases in Cook County Children's Hospital . Surg Clin North Am 1947;;27:3-22.
Thurston DL, Holowach J, McCoy EE:  Acute intussusception: Analysis of 160 cases at St Louis Children's Hospital . Arch Surg 1953;;67: 68-79.
Link to Article
Singer J:  Altered consciousness as an early manifestation of intussusception . Pediatrics 1979;;64:93-95.
Braun P, Germann-Nicod I:  Altered consciousness as a precocious manifestation of intussusception in infants . Z Kinderchir Grenzgeb 1981;;33:307-309.
Eklof O, Hartelivy H:  Reliability of the abdominal plain film in diagnosis of pediatric patients with suspected intussusception . Pediatr Radiol 1980;;9:199-206.
Link to Article
Friedman AP, Haller JO, Schneider M, et al:  Sonographic appearance of intussusception in children . Am J Gastroenterol 1979;;72:92-94.

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