What is the classic presentation of intussusception?

• A. Watery diarrhea
• B. Frank blood in stool with no pain
• C. Melena
• D. Currant jelly stools

Answer: (D)

Intussusception classically presents with episodic, crampy abdominal pain that may cause the child to draw the knees to the chest, along with vomiting. The key stool finding is currant jelly stools—stools that are thick with blood and mucus. This appearance comes from venous congestion and mucosal ischemia in the telescoped bowel, leading to mucosal sloughing that mixes with mucus as it passes into the lumen. Exam could also reveal a sausage-shaped abdominal mass in the right upper quadrant, but the distinctive jelly-like stool is the hallmark. Other stool presentations don’t fit this pattern: watery diarrhea points to gastroenteritis, frank blood in stool with no pain suggests a non-obstructive GI bleed, and melena indicates upper GI bleeding with digested blood. Currant jelly stools are the classic sign of intussusception.