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Intussusception

Intussusception is a condition in which one part of the bowel collapses, or tunnels, into an adjoining section. Intussusception most often occurs where the small bowel joins the large bowel, although it can occur anywhere in the intestine. Common symptoms of intussusception include such things as abdominal pain, bowel movements mixed with blood and mucus, and a lump in the abdomen. Treatment for intussusception may involve a barium enema or surgery.

 

What Is Intussusception?

Intussusception is a condition in which one section of the bowel tunnels into an adjoining section, like a collapsible telescope. Intussusception can occur in the colon, the small bowel, or between the small bowel and the colon. The result is a blocked small bowel or colon. Intussusception can be life threatening.
 

Who Does Intussusception Affect?

Intussusception is most common in young children in their first year of life. Intussusception affects boys more often than girls, with most cases occurring between 5 months and 3 years of age. Intussusception occurs spontaneously in approximately 1 in 2,000 healthy young infants and children per year. Intussusception can reoccur in about 1 in 10 children.
 

Where Does Intussusception Occur?

The most common place in the intestine for intussusception to occur is where the small bowel joins the large bowel. However, intussusception can occur in most parts of the intestine.
 
When intussusception does occur, the two walls of the intestines press against each other. This causes inflammation, swelling, and eventually, decreased blood flow. If intussusception is not detected early, internal bleeding, a hole in the intestines, and infection in the abdomen may occur, because the intestinal tissue has died from the decreased blood flow.
 

Causes of Intussusception

The possible causes of intussusception will vary, depending on if it occurs in a child or an adult.
 
Some possible intussusception causes include:
 
  • Viral infections, such as adenovirus
  • Growth in the small bowel or colon (a polyp or tumor)
  • Enlarged lymph gland
  • Adhesions (scar-like tissue)
  • Surgical scars in the small bowel or colon
  • Long-term diarrhea.
     
In a number of cases, the cause of intussusception is not known.
 
(Click Causes of Intussusception for more information about intussusception causes in children and adults.)
 

Symptoms of Intussusception

Infants and children with intussusception symptoms may experience:
 
  • Intermittent abdominal pain
  • Bowel movements that are mixed with blood and mucus
  • Abdominal distention (or a lump in the abdomen)
  • Fever
  • Vomiting bile
  • Diarrhea
  • Dehydration
  • Lethargy
  • Shock (low blood pressure and increased heart rate requiring immediate attention).
     
Some infants will have periods of crying in pain alternating with periods of exhausted sleep.
 
In adults, intussusception symptoms can last a long time (chronic symptoms) or they can come and go (intermittent symptoms). The intussusception symptoms will depend on the location of the intussusception.
 
(Click Intussusception Symptoms for more information about symptoms of intussusception in adults and children.)
 

Diagnosing Intussusception

In order to make an intussusception diagnosis, the doctor will ask a number of questions and perform a physical exam, looking for signs and symptoms of intussusception. If the doctor suspects intussusception, he or she will often order additional tests. Some of these tests may include:
 
  • X-rays
  • Upper and lower gastrointestinal (GI) series
  • CT scan
  • Barium enema.
     
Intussusception symptoms can be similar to symptoms seen with a number of other medical conditions, including:
 
  • Colic
  • Volvulus
  • Appendicitis
  • Gastroenteritis
  • Sepsis
  • Incarcerated hernia.
     
The doctor will consider these conditions and attempt to rule them out before making an intussusception diagnosis.
 

Treatment for Intussusception

Once a diagnosis is made, there are several intussusception treatment options available, including:
 
  • Barium enema
  • Surgery.
     
The specific treatment for intussusception that is recommended will depend on a number of factors, including:
 
  • The extent of the problem
  • The cause of intussusception
  • The age and general health of the patient.
     

Prognosis for Intussusception

With early intussusception treatment, the outcome is generally excellent. If intussusception is not diagnosed promptly, especially in children, it can cause serious damage to the portion of the bowel that is unable to get a normal blood supply.
 
In some cases, usually in children, intussusception may be temporary and reverse on its own. If no underlying cause is found in these cases, no specific intussusception treatment is required.
 
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD