The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? Select all that apply. Select all that apply.
1. Palpable olive-shaped mass in epigastrium
2. Palpable sausage-shaped abdominal mass
3. Projectile vomiting without visualized blood
4. Screaming and drawing of the knees up to the chest
5. Stool mixed with blood and mucus
Intussusception is an obstructive gastrointestinal disorder caused when a segment of the bowel slides, or telescopes, into another section. This typically occurs in infants and children age <6. Once the bowel telescopes in, pressure increases within the bowel, causing ischemia and leakage of blood and mucus into the lumen of the bowel. Classic clinical manifestations of intussusception include episodes of sudden, crampy abdominal pain; a palpable sausage-shaped abdominal mass; and red, “currant jelly” stools (Options 2 and 5). Other manifestations include inconsolable crying with the knees drawn up to the chest and vomiting (Option 4). The child may appear normal and calm between painful episodes. (Options 1 and 3) A palpable, epigastric, olive-shaped mass and non bloody projectile vomiting (ie, up to 3-4 feet [~1 meter]) are clinical manifestations often seen with pyloric stenosis. Projectile vomiting may also be a symptom of elevated intracranial pressure. However, intussusception typically causes bilious, nonprojectile vomiting and involves a sausage-shaped mass.
