Intussusception Medical Disorder

Intussusception is characterized by a fold in the intestine (picture how a telescope expands and contracts) with one part of the intestine sliding into another part. The resulting inability to pass food through the intestines is called an obstruction. According to Lucile Packard Children's Hospital at Stanford, this is the No. 1 cause of children's intestinal obstruction. Boys are four times more likely than girls to develop the condition. Rarely, adults can develop the condition.

Causes in Children

• Doctors are unsure exactly what causes the condition in children; however, there does appear to be a familial link. There is also increased risk of developing the condition for children who have cystic fibrosis, are dehydrated, have an upper respiratory infection, have gastroenteritis, have tumors or masses in the abdomen or intestines, or who have recently completed chemotherapy treatment.

Causes in Adults

• Intussusception in adults may be caused by chronic diarrhea, adhesions in the GI (gastrointestinal) tract, benign or malignant growths in the GI tract, surgical scar tissue in the colon or small intestine, irritable bowel syndrome, Hirschsprung's disease or gastroparesis (three disorders that affect the way food moves through your intestines).

Symptoms in Children

• Intussusception symptoms in children include swelling of the abdomen, fever, diarrhea, vomiting, an abdominal lump, dehydration, intermittent severe pain in the abdomen, shallow breathing and stools that contain mucus and blood. According to the Mayo Clinic, the first sign in babies is most commonly sudden bouts of loud crying resulting from abdominal pain. Infants experiencing pain in the abdomen commonly pull their knees toward their chests. The pain usually is intermittent, occurring every 15 minutes at first and coming more frequently as the condition progresses.

Symptoms in Adults

• Symptoms in adults may last for a long period of time or may present intermittently. Signs of intussusception include bleeding of the rectum, abdominal swelling, abdominal cramping, urgent bowel movements, abdominal pain localized to one specific abdominal area, differences in frequency of bowel movements, vomiting and nausea.

Complications

• If intussusception goes untreated, it can affect the intestinal blood supply. As obstruction persists, swelling in the area cuts off your blood supply to that area of your intestine. This causes intestinal tissue to die, leading to tears in the wall of your intestine. This, in turn, can lead to an infection of your abdominal cavity (peritonitis). Peritonitis requires emergency medical care. Pain, swelling, fever, decreased urination, fever and increased thirst are characteristic of the condition. The child may go into shock (indicated by dilated pupils, weak pulse, clammy skin, lackluster eyes, abnormal breathing patterns and possible loss of consciousness).

Diagnosis

• To confirm the diagnosis, your doctor will need to perform a physical examination. Blood, urine and fecal tests are commonly performed in addition to either an X-ray or CT scan to visualize any obstruction or perforation in the GI tract. Your doctor may also order an air or barium enema to visualize the colon.

Treatment

• Immediate treatment is crucial in preventing dehydration, shock and potential infections. The first line of treatment will be to receive IV fluids. Then, a nasogastric tube will be placed through your nose or your child's nose into your stomach. This allows the pressure in your GI tract to decompress.

  Air or barium enemas may be useful in correcting the fold in the intestines. If the enema does not correct the condition, surgery will be necessary to clear the obstruction.