What is intussusception?
Intussusception refers to a serious and painful condition in which a part of the intestine slides into an adjacent part of the intestine. This often blocks fluid or food from passing through.
The condition is considered a medical emergency and is the most common cause of intestinal obstruction in children under the age of 3. The condition is treatable with both surgical and nonsurgical approaches.
Intussusception is most common in children under the age of 3, who may not be able to describe their intussusception symptoms. Hence, the first symptom, in an otherwise healthy infant, maybe a sudden and loud crying because of abdominal pain.
Infants suffering from abdominal pain may pull their knees close to their chest when crying. These bouts of abdominal pain may come and go every 15 to 20 minutes at first. As time passes, these painful episodes may happen more often and last longer.
Other intussusception signs and symptoms in children include:
- Nausea and vomiting
- Stool mixed with mucus and blood
- Little or no energy
Signs of intussusception in adults include nonspecific symptoms such as abdominal pain, nausea, and vomiting. These intussusception symptoms in adults may come and go, leading people to go weeks before seeking medical help for the condition.
Who is at risk?
Risk factors for intussusception include:
- Children between the age of 6 months to 3 years
- Being a male
- Abnormal intestinal formation at birth
- A prior history of intussusception
- A family history of intussusception
Intussusception usually occurs in the small intestine, which is a long, winding tube that allows the body to absorb important nutrients.
While the exact intussusception cause is not clear always, in some cases, intussusception form due to the growth in the intestine, such as a tumor or polyp.
With the intestinal walls moving back and forth during digestion, tissue may catch on the growth, called a lead point. This may lead to some nearby tissue folding over on itself. Other intussusception causes in adults are usually a medical condition or procedures, including:
- Adhesions in the intestine
- Weight-loss surgery or other surgery on the intestinal tract
- Inflammation due to diseases like Crohn’s disease
As most children suffer from the formation of intussusception in the fall or winter with flu-like symptoms, it is suspected that a virus may play a role in the condition. In some cases, a lead point is identified to be the cause of intussusception, and most frequently is Meckel’s diverticulum, a pouch that forms in the small intestine.
How is intussusception diagnosed?
A doctor may begin intussusception diagnosis by reviewing the symptoms and performing a physical examination. The doctor may gently press on the abdomen to check for a lump or tenderness.
Additionally, some imaging tests may be required for confirmation of the diagnosis. These may include:
- Abdominal X-ray: It may show a blockage in the intestine.
- Upper gastrointestinal series or barium swallow: A special liquid, when swallowed, coats the upper gastrointestinal tract and improves the details and visibility of the upper gastrointestinal tract on an X-ray.
- Lower gastrointestinal series or barium enema: To get a detailed X-ray image of the lower part of the small intestine, liquid barium or other fluid is inserted into the rectum. In cases of mild intussusception, the folded tissue may return to its normal position because of the pressure of the barium insertion.
- An ultrasound: It can detect tissue problems and circulation disruptions.
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How is intussusception treated?
Intussusception treatment depends on the severity of the condition, the age of the child, and their general health. For treatment, a nonsurgical procedure is usually considered first.
In some cases, a barium or saline enema may be a sufficient procedure. The affected tissue may be pushed back into its original position because of the pressure from the air.
Administration of fluid through the tube into the rectum may also help the tissue in returning to its normal position.
In cases where an enema is ineffective, a surgical procedure may be needed. It is the main approach for treatment in adults with intussusception and in children who are very ill with the condition.
The operation requires an incision in the belly under general anesthesia. The surgeon may manually restore the intestine to its normal and healthy position. In case of any tissue damage, a part of the intestine may have to be removed.