It is usually the result of a benign cause. However, it may be difficult to distinguish serious causes from benign causes if the evaluation is superficial. Whenever the chief complaint is vomiting, the diagnosis of intussusception should be considered. The history and examination should be directed at determining whether intussusception is possible based on clinical grounds. The chart should include comments in the history regarding the frequency of vomiting, the color of the emesis, the presence or absence of abdominal pain, the frequency of abdominal pain, and the activity level of the child.
Intussusception is more likely if the child exhibits lethargy.
The absence of these symptoms does not rule out intussusception. Patients with intussusception may have all, some, or none of these symptoms. The physical exam portion of the chart should document the presence or absence of lethargy and an abdominal mass. The rectal exam and stool guaiac results should also be recorded. Ideally, the chart should comment on whether the examiner has noted a colicky abdominal pain pattern observed during the evaluation period.