Intussusception

Definition

Definition

Intussusception is a serious type of bowel obstruction. The intestine is shaped like a long tube. Intussusception occurs when one part of the intestine slides up into another part of the intestine. This part of the intestine becomes trapped and starts to swell. The swelling can block the flow of food. If severe, swelling can also cut off the blood supply to the area.

Intussusception

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Causes

Causes

In many cases, there is no known cause for intussusception. However, intussusception may sometimes occur as a complication of some medical conditions, including:

Risk Factors

Risk Factors

Intussusception is more common in children 3 months to 6 years old, but the majority are younger than 24 months. It is also more common in males.

Factors that increase the risk of intussusception include:

  • Season: more common during respiratory and gastrointestinal virus seasons
  • Medical conditions in the list above

Symptoms

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
  • Vomiting—sometimes yellow or green tinged
  • Stools mixed with mucus and blood—often described as currant jelly
  • Lethargy

Additional symptoms include:

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
  • Inflammation of the lining of the abdominal cavity and infection—peritonitis

If not treated quickly, peritonitis can lead to death.

Diagnosis

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests

Images may be taken of your bodily structures. This can be done with:

Treatment

Treatment

Air Enema

In many cases, giving an air enema will correct intussusception. Air enema is preferred over water-soluble contrast or barium enema. This is often the preferred treatment when intussusception occurs in infancy. However, the test may cause a perforation to occur in the bowel. An enema should not be done if 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.

Prevention

Prevention

There are no guidelines for preventing intussusception because the cause is unknown. Talk to your doctor about avoiding vaccines that may cause a recurrence.

RESOURCES:

Family Doctor—American Academy of Family Physicians http://www.familydoctor.org

Centers for Disease Control and Prevention http://www.cdc.gov

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca

Health Canada http://www.hc-sc.gc.ca

References:

Abdominal pain in infants. American Academy of Pediatrics Healthy Children website. Available at:
http://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Abdominal-Pains-in-Infants.aspx
Updated March 28, 2014. Accessed August 12, 2014.

Intussusception. Family Doctor—American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/intussusception.html
Updated August 20, 2015. Accessed September 15, 2015.

Intussusception. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated September 1, 2014. Accessed September 15, 2015.

Questions and answers about intussusception. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/vaccines/vpd-vac/rotavirus/intussusception-FAQs.htm
Updated April 8, 2014. Accessed September 15, 2015.

Last reviewed September 2015 by Kari Kassir, MD
Last Updated: 9/30/2013

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