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Intussusception

Definition:
Intussusception is a relatively rare but very serious type of bowel obstruction. The bowel (also called intestine) is shaped like a long tube. Intussusception occurs when a part of the bowel “telescopes” in on itself and is trapped by an adjacent portion of the small or large intestine. This causes obstruction and cuts off the blood supply to the intestine.

Causes:
In many cases, there is no known cause for intussusception. However, intussusception may sometimes occur as a complication of some medical conditions, including:
  • Viral infections
  • Appendicitis
  • Meckel's diverticulum
  • Intestinal polyps
  • Tumors
  • Lymphoma
  • Leukemia
  • Foreign bodies
  • Cystic fibrosis
  • Recent abdominal surgery
  • Henoch-Schonlein purpura
  • Hemolytic uremic syndrome
  • Post-abdominal trauma
  • Inflammatory bowel disease
  • Hemangioma
Risk Factors:
A risk factor is something that increases your chances of getting a disease or condition.
  • 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.
  • 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
  • Lethargy
  • Poor feeding
  • Vomiting
  • Diarrhea
  • Stools mixed with mucus and blood (often described as currant jelly)
  • Fever
  • Pallor
  • Shock
  • Dehydration

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
  • Peritonitis (inflammation of the lining of the abdominal cavity) and infection

If not treated quickly, peritonitis can lead to death.

Diagnosis:
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
  • Blood and urine tests
  • Fecal occult blood test, which checks the stool for blood
  • Abdominal x-ray, ultrasound, or CT scan
Treatment:
Air Enema
In many cases, giving an air enema will correct intussusception. This is often the preferred treatment when intussusception occurs in infancy. However, the test may occasionally cause a perforation to occur in the bowel. No form of enema should be done if the doctors know 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.

After any treatment, intussusception may recur.

Prevention:
There are no guidelines for preventing intussusception because the cause is unknown.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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