Delirium: Where Are We Now?

Delirium has long been recognized within the adult intensive care world, but it is only within the past decade that its presence and prevalence in the context of pediatric intensive care has been studied. There is now a greater understanding of risk factors for delirium, a better selection of methods to recognize it, and treatment specifically directed to pediatric patients. An understanding of delirium is also relevant to pediatricians practicing outside of the intensive care unit, as delirium can present in other care environments, where it remains under-recognized. The purpose of this article is to review pediatric delirium by discussing its pathophysiology, the tools available to screen patients, and current prevention and management approaches. [Pediatr Ann. 2024;53(8):e288-e292.].

Intussusception With a Pathological Lead Point in a Two-Month-Old Infant.

Intussusception is one of the most common causes of acute intestinal obstruction in infancy and early childhood. Most cases of intussusception tend to occur in infancy, between the ages of four and six months. The causes can be split into two categories: non-pathologic and pathologic. Non-pathological causes include administration of the rotavirus vaccine, dehydration, and recent illness. Pathological causes can be attributed to Meckel's diverticulum (in 75% of cases), polyps (15%), and lymphoma or other tumors (3%). Intussusception rarely occurs in infants less than three months of age. If intussusception does occur in patients under three months of age, the cause is idiopathic in up to 75% of the cases. Additionally, myoglandular-type polyps are exceedingly rare and very rarely occur in patients under the age of 50. This case report discusses the diagnosis and treatment of intussusception in a two-month-old male patient who initially presented to the pediatric inpatient unit for dehydration secondary to a suspected viral illness, later developing colicky abdominal pain and bloody stools. He was found to have colo-colonic intussusception with a myoglandular-type polyp lead point. In discussing this case, the aim is to teach about intussusception and myoglandular-type polyps, as well as reveal a rarity in both etiologies for this age group.