Overview
Intussusception is a medical condition in which one part of the intestine slides into an adjacent part, blocking food or fluid from passing through. This telescoping action can lead to infection, tissue death, or a bowel tear if left untreated. It is the most common cause of intestinal obstruction in children under 3 years old and is rare in adults. Symptoms include sudden and recurrent abdominal pain, vomiting, and a lack of obvious pain in some cases. Intussusception requires immediate medical attention.
Understanding the disease
Symptoms
The symptoms of intussusception can vary depending on the age and individual. In infants, common symptoms include sudden, loud crying caused by belly pain, pulling their knees to their chests when they cry, and pain episodes that come and go every 15 to 20 minutes. Older children may experience intermittent abdominal pain, nausea, vomiting, and a lump in the abdomen. Adults may exhibit persistent belly pain, nausea, and vomiting, although the condition is rare in adults and symptoms may overlap with other disorders. Intussusception requires immediate medical attention, as it can lead to serious complications, including perforation and peritonitis.
Risk Factors
The risk factors for developing intussusception include:
- Age: Children, especially young children, are more likely to develop intussusception than adults. It's the most common cause of bowel obstruction in children between the ages of 6 months and 3 years.
- Sex: Intussusception more often affects boys.
- Irregular intestinal formation at birth: Intestinal malrotation is a condition in which the intestine doesn't develop or rotate correctly, increasing the risk of intussusception.
- Certain conditions: Some disorders can increase the risk of intussusception, including cystic fibrosis, Henoch-Schonlein purpura (IgA vasculitis), Crohn's disease, and celiac disease.
Development
Intussusception occurs when a segment of the intestine slides into the adjacent section, causing it to telescope. The most common cause of intussusception in children is unknown, but it can be associated with gastroenteritis or viral infections. In adults, intussusception is usually caused by an underlying medical condition such as a polyp, tumor, or adhesions. In some cases, intussusception can be related to a congenital condition such as intestinal malrotation or a pouch in the lining of the small intestine (Meckel's diverticulum).
Assessment and Diagnosis
Diagnosis
To diagnose intussusception, a healthcare provider will start by taking a history of the symptoms and may be able to feel a sausage-shaped lump in the belly. To confirm the diagnosis, imaging tests such as an ultrasound, X-ray, or CT scan may be ordered. These tests can reveal intestinal obstruction caused by intussusception and show a "bull's-eye" pattern representing the intestine coiled within the intestine. Imaging can also show if the intestine has been torn (perforated).
Management and Treatment
Complications
Potential complications of intussusception include a lack of blood supply to the affected portion of the intestine, leading to tissue death, a tear in the intestinal wall called perforation, and infection of the lining of the abdominal cavity known as peritonitis. Peritonitis is a life-threatening condition that requires immediate medical attention, and symptoms include belly pain, swelling, fever, vomiting, cool and clammy skin, rapid pulse, shallow or rapid breathing, anxiety or agitation, and extreme listlessness.
Treatment
Treatment for intussusception typically involves either reducing the intestinal blockage or removing the blocked section of the intestine. In children, the intestines can usually be pushed back into position with a minor procedure, such as an enema or hydrostatic reduction. This procedure involves injecting air or fluid into the affected area to gently push the intestines back into their proper position. However, if the intussusception is caused by an underlying condition such as a tumor or polyp, surgical intervention may be necessary. In adults, surgery is often required to correct the problem. In severe cases or when there are complications, hospitalization and further medical intervention may be necessary. Prompt medical attention is crucial to prevent serious complications, such as bowel obstruction, infection, or peritonitis.
Preparing for medical consultation
It is important to consult with a healthcare professional for specific guidance and recommendations on preparing for an appointment related to intussusception.