Hopefully you’ve checked out part 1, part 2, and part 3.

Though ileocolic is the most common type – small bowel-small bowel occur as well. Generally they present with similar symptoms (intermittent colicky pain etc,.). They are also diagnosed similarly with ultrasound being the best study, but CTs can show them too. They are more likely to reduce spontaneously if:

  • They are ileal-ileal
  • They are shorter than 2.3cm

 

Munden et al. investigated a series of patients with isolated small bowel-small bowel intussusception. All cases with length <3.5cm reduced spontaneously. Those that needed to go to surgery had a mean length of 7.3cm  

[95% CI 4.8-9.7 cm].

Interestingly, many of these will be discovered incidentally when looking for other diagnoses. My recommendation is to manage conservatively if the child looks well. If not, and they have peritoneal signs then consult surgery. Nonoperative reduction techniques may not be successful, but could be trialed in the right situations.