Intussusception

Definition

Intussusception is a serious type of bowel obstruction. The intestine is shaped like a long tube. Intussusception occurs when one part of the intestine slides up into another part of the intestine. This part of the intestine becomes trapped and starts to swell. The swelling can block the flow of food. If severe, swelling can also cut off the blood supply to the area.
Intussusception
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Causes

In many cases, there is no known cause for intussusception. However, intussusception may sometimes occur as a complication of some medical conditions, including:

Risk Factors

Factors that increase the risk of intussusception include:
  • Age: it is the most common cause of obstruction in children 3 months to 6 years old, but the majority are younger than 24 months
  • Season: more common during respiratory and gastrointestinal virus seasons
  • Sex: male
  • Medical conditions in the list above

Symptoms

The initial symptoms may include:
  • Abdominal pain:
    • Usually severe
    • Colicky or cramping
    • Usually comes on suddenly
    • In children, this may be indicated by drawing knees to chest and crying
  • Vomiting—sometimes yellow or green tinged
  • Stools mixed with mucus and blood—often described as currant jelly
  • Lethargy
Additional symptoms include:Intussusception cuts off the blood supply to the bowel. If this is not treated quickly, it can lead to bowel gangrene. Gangrene can cause tissue in the intestinal wall to die. This may lead to:
  • Perforation of the intestinal wall
  • Inflammation of the lining of the abdominal cavity and infection—peritonitis
If not treated quickly, peritonitis can lead to death.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.Bodily fluids may be tested. This can be done with:
  • Blood tests
  • Urine tests
Images may be taken of your bodily structures. This can be done with:

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Treatment

Air Enema

In many cases, giving an air enema will correct intussusception. Air enema is preferred over water-soluble contrast or barium enema. This is often the preferred treatment when intussusception occurs in infancy. However, the test may cause a perforation to occur in the bowel. An enema should not be done if the bowel is perforated.

Surgery

Surgery may be required to release the trapped portion of the bowel and to clear the obstruction. If any bowel tissue has died due to gangrene, that part of the bowel may need to be removed.

Prevention

There are no guidelines for preventing intussusception because the cause is unknown. Talk to your doctor about avoiding vaccines that may cause a recurrence.

RESOURCES

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

Centers for Disease Control and Prevention
http://www.cdc.gov

CANADIAN RESOURCES

About Kids Health
http://www.aboutkidshealth.ca

Health Canada
http://www.hc-sc.gc.ca

References

Abdominal pain in infants. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Abdominal-Pains-in-Infants.aspx. Updated March 28, 2014. Accessed August 12, 2014.

Intussusception. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/intussusception.html. Updated March 2014. Accessed August 12, 2014.

Intussusception. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 12, 2013. Accessed August 12, 2014.

Questions and answers about intussusception. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/rotavirus/intussusception-FAQs.htm. Updated April 8, 2014. Accessed August 12, 2014.

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