Intussusception

Description

Intussusception (in-tuh-suh-SEP-shun) is a severe condition in which a part of the intestine slides into an adjacent part of the intestine. This telescoping action often blocks food or fluid to pass through. Intussusception also cuts off the blood supply to part of the intestine that is affected. This can lead to infection, the death of bowel tissue or a tear in the intestine, it is called a perforation.

Intussusception is the most common cause of intestinal obstruction in children younger than 3 years of age. The cause of most cases of intussusception in children is unknown. Although intussusception is rare in adults, most cases of adult intussusception are the result of an underlying medical condition, such as a tumor.

In children, the intestines, it can usually be pushed back into position with a minor procedure. In adults, surgery is often needed to correct the problem.

Symptoms

Children

The first sign of intussusception in healthy children it may be sudden, strong tears caused by the pain of the belly. Babies who have abdominal pain can pull your knees to your chest when you cry.

The pain of the intussusception comes and goes, usually every 15 to 20 minutes at first. These painful episodes last longer, and more frequently as time passes.

Other symptoms of intussusception include:

  • Stool mixed with blood and mucus, sometimes referred to as the jelly of currant stool because of its appearance.
  • Vomiting.
  • A lump in the belly.
  • Weakness or lack of energy.
  • The diarrhea.

Not everyone has all the symptoms. Some babies have no obvious pain. Some children do not pass through the blood or having a lump in the belly. And some of the older children have pain but no other symptoms.

Adults

Intussusception is rare in adults. Also, because the symptoms of the disease often overlap with symptoms of other disorders, it is more difficult to identify. The most common symptom is abdominal pain that comes and goes. Nausea and vomiting may also occur. Sometimes people have symptoms for weeks before seeking medical attention.

When to see a doctor

Intussusception requires emergency medical attention. If you or your child has the symptoms listed above, seek medical help immediately.

In infants, pull your knees toward your chest and crying are often symptoms of belly pain.

Causes

The intestine has the form of a long tube. In intussusception, a part of your bowel, usually the small intestine slides into an adjacent part. This is sometimes called telescoping, because it is similar to the way a telescope folding slide together.

In some cases, in adults, the spring system is caused by a tumor in the bowel, such as a polyp or a tumor, called the initiative of the point. The typical wavelike contractions of the intestine grab this initiative of the point and pull it and the lining of the intestine in the intestine in front. In most cases, however, cannot determine the cause of the intussusception.

Children

In the majority of cases of intussusception in children, the cause is unknown. Intussusception appears to occur more frequently in the fall and winter. And because many children with the condition also have symptoms similar to the flu, some suspect that a virus may play a role in the disease. Sometimes, a point can be identified as the cause of the disease — most often on the initiative of the point is a pouch in the lining of the small intestine (Meckel's diverticulum).

Adults

In adults, intussusception is usually the result of a medical condition or procedure, including:

  • A polyp or tumor.
  • The scar-like tissue in the small intestine, known as adhesions.
  • Weight-loss surgery, such as gastric bypass surgery or surgery in the intestinal tract.
  • The inflammation in the intestines due to diseases such as Crohn's disease.

Risk factors

The risk factors of intussusception include:

  • Age. Children — especially young children — are much more likely to develop intussusception adults. It is the most common cause of intestinal obstruction in children between the ages of 6 months and 3 years.
  • Sex. Intussusception occurs more often in males.
  • Irregular bowel training in the birth. Intestinal malrotation is a condition in which the gut is not developed or rotate correctly. This increases the risk of intussusception.
  • Certain conditions. Some disorders may increase the risk of intussusception, including: Cystic fibrosis.Henoch-schonlein purpura, also known as IgA vasculitis.Crohn's disease.The celiac disease.
  • Cystic fibrosis.
  • Henoch-schonlein purpura, also known as IgA vasculitis.
  • Crohn's disease.
  • The celiac disease.
  • Cystic fibrosis.
  • Henoch-schonlein purpura, also known as IgA vasculitis.
  • Crohn's disease.
  • The celiac disease.

Complications

Intussusception can cut off the blood supply to the affected part of the intestine. If left untreated, the lack of blood causes the tissue of the intestinal wall to die. The death of the tissues can lead to a tear in the intestinal wall, called a perforation. This can cause an infection in the lining of the abdominal cavity, known as peritonitis.

Peritonitis is a life-threatening condition that requires immediate medical attention. The symptoms of peritonitis are:

  • Belly pain.
  • Swelling in the belly area.
  • Fever.
  • Vomiting.

Peritonitis can cause your child to go into shock. Symptoms of shock include:

  • Cold, cold and clammy skin that may be pale or gray.
  • A weak and rapid pulse.
  • Breathing may be slow and shallow, or very fast.
  • Anxiety or agitation.
  • Extreme apathy.

A child that is in a state of shock can be conscious or unconscious. If you suspect that your child is in a state of shock, seek emergency medical attention immediately.

Intussusception

Diagnosis

Your or your child's health care provider will start by getting a history of the symptoms of the problem. The provider may be able to feel a sausage-shaped lump in the belly. To confirm the diagnosis, your doctor may order:

  • Ultrasound, or other abdominal imaging. An ultrasound, X-ray or computerized tomography (CT) scan can reveal intestinal obstruction caused by intussusception. The image will usually show a "bull's eye", which represents the intestine coiled in the gut. Abdominal imaging can also show if the intestine has ruptured (perforated).

Treatment

The treatment of intussusception in general, occurs as a medical emergency. Emergency medical attention is necessary to prevent severe dehydration and shock, as well as the prevention of the infection that can occur when a portion of the bowel dies due to lack of blood.

Treatment options for the intussusception may include:

  • A water soluble contrast or air enema.This is a procedure of diagnosis and treatment. If an enema works, further treatment is usually not necessary. This treatment can really solve intussusception 90% of the time in children, and no further treatment is needed. If the intestine is ruptured (perforated), this procedure may not be used. Intussusception is repeated up to 20% of the time, and the treatment will have to be repeated. It is important that the surgeon be consulted even if the treatment with enema planned. This is due to the small risk of a tear or rupture of the intestine, with this therapy.
  • Surgery. If the intestine is broken, if an enema is successful in correcting the problem or if the item is the cause, surgery is necessary. The surgeon will free the portion of the intestine is trapped, remove the obstruction and, if necessary, to remove all of the intestinal tissue that has died. Surgery is the main treatment for adults and for people who are seriously ill.

A water soluble contrast or air enema. This is a procedure of diagnosis and treatment. If an enema works, further treatment is usually not necessary. This treatment can really solve intussusception 90% of the time in children, and no further treatment is needed. If the intestine is ruptured (perforated), this procedure may not be used.

Intussusception is repeated up to 20% of the time, and the treatment will have to be repeated. It is important that the surgeon be consulted even if the treatment with enema planned. This is due to the small risk of a tear or rupture of the intestine, with this therapy.

In some cases, the intussusception may be temporary and go away without treatment.

Preparing for your appointment

Emergency medical attention is needed for the treatment of intussusception. You may not have much time to prepare for an appointment.

What to expect from your doctor

Your child's health care provider is likely to ask several questions, including:

  • When did your child begin to experience stomach pain or other symptoms?
  • Does the pain of your child appear to be continuous or is going on and off?
  • Does the pain begin and end suddenly?
  • Has your child experienced nausea, vomiting, or diarrhea?
  • Have you noticed the presence of blood in the stool of your child?
  • Have you noticed any swelling or a lump in the abdomen of his son?

What you can do in the meantime

Do not give your child nonprescription medications to treat the symptoms prior to the appointment. Do not give your child something to eat, if you notice any of the symptoms of intussusception. Seek medical attention right away.

Symptoms and treatment of Intussusception