DRUG INDEX
Intussusception
What is intussusception?
Intussusception is the infolding, like the closing of a telescope, of a segment of the small intestine into the adjacent but more distal ("downstream") segment of the intestine. (The term "intussusception" is pronounced "in-tu-su-ception" with the accent on the "in". It comes from the Latin "intus", within + "suscipere", to receive = to receive within).
What does intussusception do?
Intussusception causes the compression of blood vessels in the involved intestine which reduces the supply of blood to the affected intestine. If the blood supply is greatly reduced, the involved intestine may die (become gangrenous) and bleed. It also may rupture and lead to abdominal infection and shock.
The enveloping of a segment of the intestine into the adjacent segment also narrows the adjacent portion of the intestine. The lack of blood to the intestine causes it to swell, which further narrows the intestine. Inflammation develops and causes further swelling. Eventually, the swelling completely blocks the intestine.
Is intussusception an urgent problem?
Absolutely. Intussusception is an emergency!
Is intussusception a problem confined to infancy?
Most cases of intussusception occur in children between 5 months and 1 year of age. Boys develop the condition 3 times more often than girls. Intussusception can also occur in adults and older children, although it is uncommon.
What causes intussusception?
The causes of intussusception are not fully known. Viral infections of the intestine may possibly contribute to intussusception in infancy.
Intussusception is very rare in older children in whom the presence of a polyp or a tumor may trigger the intussusception. A polyp or tumor is a common cause of intussusception in adults.
Why is rapid diagnosis of intussusception important?
Early diagnosis of intussusception is essential in order to prevent death of the intestine as well as the patient.
What are the symptoms of intussusception?
The primary symptom of intussusception is abdominal pain . Intussusception in an infant usually starts with the infant suddenly crying very loudly, as if in great pain. The infant intermittently draws the knees up to the chest while crying. This reaction is caused by the abdominal pain which recurs frequently and increases in intensity and duration. Fever also is common.
As the condition progresses, the infant becomes weak and then shocky with pale color, lethargy, and sweating.
About half of affected infants pass bloody mucousy stool ("currant jelly" stool).
How is intussusception diagnosed?
The history of abdominal pain, as described above, can suggest intussusception, which is characteristic in infants, but not in adults or older children. On examining the abdomen, the doctor may feel a mass (the intussusception itself). Although a plain abdominal X-rays can indicate an intestinal obstruction, a barium enema is needed to show the distinctive infolding of the bowel.
Is it necessary to operate when there is intussusception?
The treatment of intussusception may or may not require surgery. In some cases, the intestinal obstruction can be reversed with a barium enema. The enema carries a risk of intestinal rupture and cannot be done if the bowel has already perforated.
If the intestinal obstruction cannot be reversed by a barium enema, surgery is necessary to reverse the intussusception and relieve the obstruction. If a portion of the intestine has become gangrenous, it must be removed. After surgery, intravenous feeding and fluids are continued until normal bowel movements resume.
What is the prognosis (outlook) for patients with intussusception?
The outlook for intussusception is usually good with early diagnosis and treatment. Early detection and treatment are paramount!
Intussusception At A Glance - Intussusception is the infolding (telescoping) of one segment of the intestine within another.
- Intussusception usually results in a blockage of the intestine.
- Intussusception occurs primarily in infants (boys more often than girls) but can also occur in adults and older children.
- The primary symptom of intussusception is abdominal pain.
- Early diagnosis and treatment of intussusception are essential to save the intestine and the patient.
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