Intussusception is a serious medical condition in which part of the intestine slides into the section next to it. It is sometimes referred to as 'telescoping.' This can cause partial or complete bowel obstruction, and it can cut off blood supply to part of the intestine.
This condition usually happens in the small bowel. Intussusception is most commonly seen in children under the age of 3, and the cause in most cases is unknown. In adults, the cause of intussusception is usually from a previously existing medical condition, like a tumor.
Intussusception must be treated immediately. Left untreated, it can lead to the death of bowel tissue, bowel perforation, infection, sepsis, and death. The following are the most common causes and treatments of intussusception.
Infants who experience intussusception may suddenly begin to cry from severe abdominal pain. The infant or young child may pull their legs to their chest. The pain for this condition is usually intermittent, occurring every 15-20 minutes. As time passes, the painful episodes may last longer and longer.
At first, episodes of vomiting may be reflexive and not accompanied by nausea. As the condition progresses and intestinal obstruction occurs, the patient may become nauseated. A young child who is repeatedly vomiting should be seen by a medical professional as soon as possible.
The stool of a person with intussusception is sometimes referred to as “currant jelly” stool because of its appearance. The patient may pass stool that is mixed with blood, mucus, and sloughed mucosa. Diarrhea may also be an early sign of intussusception.
An intussusception patient may appear very tired, weak, and lack energy. Sometimes, this is the sole presenting symptom which can make the diagnosis difficult, especially in young children.
In severe cases, or when there is a complete intestinal obstruction, an abdominal mass may be visible. It may be easier to see between painful episodes when the infant or young child is not contracting his or her muscles or pulling knees to the chest.
Sometimes the whole stomach may look bloated or distended.
If your child has a fever along with any of the symptoms mentioned above, it’s time for a visit to the closest emergency care center.
Fever itself is not a symptom of intussusception, but it indicates infection in the body. If the bowel has become necrotic (if the tissue has died), it may have caused bowel perforation, which can lead to infection and sepsis.
In young children with intussusception, an air or barium enema is the first line of treatment. In this procedure, the colon is filled with contrast material that is visible on an x-ray. This helps to confirm the diagnosis, but often, the procedure itself fixes the problem.
In 90% of cases, children aged five months to 3 years are responsive to nonoperative procedures, like the air or barium enema.
In up to 10% of cases, intussusception recurs within 24 hours, and the treatment needs to be repeated.
When an underlying medical problem causes intussusception, when it occurs in the small intestine, and when it occurs in children over the age of three or in adults, surgery may be required.
The surgeon will open the abdomen and first determine if they can manually squeeze the intestine back into place. If that is not possible, the surgeon may attempt to reduce intussusception by pulling segments of the intestine apart with forceps.
In severe cases where necrosis has occurred, the surgeon will resect— or remove— the damaged or dead tissue.
If you think your child may have intussusception, don’t wait to see a doctor. If this condition is caught early, the prognosis is very good.
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