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Intussusception

more about Intussusception


  • Intussusception is a condition in which one part of the intestines slides into the next lower part.
  • Intussusception is one of the most common causes of intestinal obstruction in infants.  It can occur at any age, but usually affects infants 1 to 2 years old.  It is rare in those older than 2.  It happens much more often in boys than girls.
  • In this condition, a part of the intestines slides into the next lower part.  That is, there is a "telescoping" effect.  This can lead to abdominal pain, obstruction, bleeding, and potentially may compromise the blood supply to the bowel.
  • Treatment needs to be started immediately.  Sometimes a barium enema will not only diagnose the problem, but also treat it.  At other times, surgery may be necessary.

  • Intussusception usually begins with a sudden onset of stomach pain that causes the child to cry and pull his legs up to his chest.  Initially, the pain may come and go.  However, as time passes, the pain becomes more severe and lasts longer.
  • Vomiting
  • Stool that looks like "currant jelly."  (This is the classic description of the stool passed by individuals with intussusception, in which blood and mucous mix to produce this distinctive appearance.)
  • Depending on the severity of the problem, there may be fever, Dehydration, and/or shock.
  • Weakness and restlessness
  • Stomach bloating, distention
  • On exam, the doctor may notice high-pitched bowel sounds.  Also, a fullness or mass may be present in the upper right part of the stomach.

  • Telescoping" into a lower part of the intestine can reduce or even cut off the blood supply to that part, causing it to become swollen and inflamed.  If the blood supply is cut off completely, there is danger of the involved part dying.  This can lead to intestinal bleeding, intestinal blockage, perforation of the intestine, and/or peritonitis (an infection of the abdominal cavity).
  • Often, the cause of this condition is not known.
  • In some cases, it is believed that a virus may be the cause.  In other cases, a polyp, tumor, or other mass within the intestinal tract is "caught" by the normal contractions of the intestines and pushed along, causing intussusception.

  • The physical exam may reveal an abdominal mass.  The stomach is usually tender to the touch.
  • Vital signs may show an elevated heart rate, fever, or low blood pressure.
  • Abdominal X-rays may show an obstruction.
  • One of the best tests is a barium enema.
  • An abdominal CT scan can also help in making the diagnosis.
  • If the diagnosis is still not certain, a laparoscopy can be done.  In this procedure, a camera is inserted into the abdominal cavity so that the surgeon can look at the intestines and identify what is causing the problem.

  • Conditions that increase the risk of developing polyps (such as Peutz-Jeghers syndrome or Gardner's syndrome) all increase the chance of developing intussusception.
  • Certain viral infections increase the risk of developing intussusception.
  • Any tumor or growth within the intestines can lead to this condition.

  • It is very important that this condition is diagnosed and treated early.  Initially, the segment of the intestine that is involved may only have a reduction in blood flow.  If the condition is treated quickly, the portion of intestine may be saved.  However, if there is a delay in treatment, circulation may be completely cut off.  If this occurs, the involved portion of the intestine dies and will have to be removed.
  • In addition to diagnosing, a barium enema can also be used to treat the condition in many (up to 75%), uncomplicated cases.  Simply by performing the enema, the intestine gets pushed back into place, resolving the problem.
  • If the enema fails or there is a suspicion that part of the intestine is dead, then surgery is required.  Surgery is also done if an intestinal perforation is suspected.  During surgery, the intestine is pushed back into place and dead portions are excised.
  • In addition to surgery, the person may need intravenous fluids.  If there is the possibility of an infection, then appropriate antibiotics will be given.
  • With quick treatment, prognosis is very good.

  • Dehydration -- if the patient cannot consume enough liquids, he may become dehydrated.
  • Bowel infarction leading to bowel resection -- if the blood supply to the involved portion of the intestine is completely cut off, it will die and have to be removed surgically.
  • Intestinal obstruction -- the intestines become blocked
  • Intestinal perforation -- a hole is formed in the wall of the intestines.  This can lead to severe infections of the abdomen.
  • Sepsis -- in this condition, the infection spreads into the blood stream and can be life- threatening.

  • This condition is a medical emergency and requires immediate medical attention.  Go to the nearest emergency room or call 911.

  • There is no specific way to prevent this condition.




more about Intussusception


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