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.
Intussusception is most common in young children in their first year of life. It affects boys more often than girls, with most cases occurring between 5 months and 3 years of age. The condition occurs spontaneously in approximately 1 in 2,000 healthy young infants and children per year. It can reoccur in about 1 in 10 children.
The most common place in the intestine for intussusception to occur is where the small bowel joins the large bowel. However, it 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 it 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 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.
Symptoms of Intussusception
Infants and children with 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, 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.
In order to make an intussusception diagnosis, the healthcare provider will ask a number of questions and perform a physical exam, looking for signs and symptoms of intussusception. If the healthcare provider 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.
- Colic
- Volvulus
- Appendicitis
- Gastroenteritis
- Sepsis
- Incarcerated hernia.
The healthcare provider will consider these conditions and attempt to rule them out before making an intussusception diagnosis.
Once a diagnosis is made, there are several intussusception treatment options available, including:
The specific treatment 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.
(For more information, click Intussusception Treatment.)
Prognosis for Intussusception
With early 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 treatment is required.
