'Knocked out'--an early sign of intussusception

In the July 1979 issue of Pediatrics, Singer reported two cases of intussusception in which altered consciousness was an early manifestation. Singer considered that such findings were atypical except in the case of moribund children with prolonged intussusception, fluid and electrolyte imbalance, blood loss, and/or strangulation of the bowel. Actually it has long been known that neurologic signs and symptoms are commonly seen early in this disorder. More than 30 years ago, in a study of acute intussusception in 95 infants and children, Oberhelman and Condon reported that "shock or impending shock as an early (the italics are ours) symptom is not adequately stressed in the literature" (Surg Clin North Am 27:3-22, 1947).