Painless intussusception and altered mental status

Am J Emerg Med. 1999 Jul;17(4):345-7. doi: 10.1016/s0735-6757(99)90082-7.


A 7-month-old child presented to the emergency department (ED) with 2 hours of painless, nonprojectile emesis and a normal mental status. Over a 3-hour period in the ED, the child remained pain-free, but developed hematemesis, hematochezia, and lethargy, progressing to unresponsiveness. The patient was evaluated for toxic ingestion, intracranial bleed, sepsis/meningitis, and intraabdominal pathology. The diagnosis was made by an abdominal ultrasound, which demonstrated an ileal-cecal intussusception that ultimately required surgical reduction. This case illustrates an insidious and poorly understood presentation of a common childhood affliction, as well as the utility of abdominal ultrasound in evaluating a hemodynamically stable patient with intussusception.

Publication types

  • Case Reports

MeSH terms

  • Consciousness / physiology
  • Diagnosis, Differential
  • Gastrointestinal Hemorrhage / etiology
  • Hematemesis / etiology
  • Humans
  • Ileal Diseases / complications*
  • Ileal Diseases / diagnostic imaging
  • Ileal Diseases / surgery
  • Ileocecal Valve* / diagnostic imaging
  • Ileocecal Valve* / surgery
  • Infant
  • Intussusception / complications*
  • Intussusception / diagnostic imaging
  • Intussusception / surgery
  • Male
  • Sleep Stages / physiology*
  • Ultrasonography
  • Unconsciousness / etiology
  • Vomiting / etiology