- Should be a differential diagnosis of abdominal pain in under-5s
- Typically presents with attacks of severe colicky pain 10 – 20 minutes apart – parents report children drawing up legs to abdomen/kicking legs
- Onset usually acute but may be insidious
- Occasionally lethargy can be the only symptom (try that as a differential diagnosis problem)
- Bilious vomiting indicates obstruction, but note that vomiting is initially clear
- Bloodstained stools (eventually redcurrant jelly) are a late sign which show loss of blood supply to intestinal mucosa
- Fever is a late sign
- Examination between symptoms may find a sausage-shaped mass in the RUQ with emptiness in the RIF.