Issue 2/2026
Tolekovа, N.
Pediatric Surgery, National Medical University Hospital „N. I. Pirogov“ – Sofia
Ileocolic intussusception is the most common acute abdominal surgical condition in early childhood and is characterized by the intrusion of a segment of the intestine into a distally located part, leading to mixed obstructive and strangulating obstruction. The disease occurs at a frequency of 2-4 per 1,000 children, most often between 4 and 36 months of age, and in 80-90% of cases it is idiopathic, often associated with viral infections and hypertrophy of Peyer’s patches. Organic landmarks are found in 10-20% of children, especially those over 3 years of age. The clinical presentation is characterized by intermittent colicky pain, vomiting, and rectal hemorrhage, although this classic triad rarely occurring. Abdominal ultrasound is the method of choice, demonstrating characteristic findings such as “target sign” and “pseudokidney sign”. Plain radiography offers limited diagnostic utility, while computed tomography is reserved for cases with diagnostic uncertainty. The main therapeutic approach is non-operative reduction, which has a success rate of about 83-85% and a low risk of complications. Hydrostatic reduction under ultrasound guidance is an alternative with lower radiation exposure. Surgical treatment is used in cases of contraindications for non-surgical reduction, recurrent intussusception or proven organic cause. Timely diagnosis and appropriate treatment significantly reduce the risk of necrosis and the need for bowel resection.
Key words: intussusception, abdominal ultrasound, nonoperative reduction, operative treatment
Address for correspondence:
Dr. Nadejda Ivanova Tolekova
Pediatric Surgery, N.I. Pirogov University Hospital
and Medical Center
21, „Totleben“, Blvd.
1606, Sofia
e-mail: nadejda.tolekova@gmail.com