Definition

Intussusception is a serious type of bowel obstruction. The intestine is shaped like a long tube. Intussusception occurs when one part of the intestine slides up into another part of the intestine. This part of the intestine becomes trapped and starts to swell. The swelling can block the flow of food. If severe, swelling can also cut off the blood supply to the area.

Intussusception

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Causes

In many cases, there is no known cause for intussusception. However, intussusception may sometimes occur as a complication of some medical conditions, including:

    
  • Viral infections—especially adenovirus
  • Meckel's diverticulum
  • Intestinal polyps
  • Tumors, such as lymphosarcoma and neurofibroma
  • Lymphoma
  • Cystic fibrosis
  • Recent abdominal surgery
  • Henoch-Schonlein purpura
  • Inflammatory bowel disease
  • Hemophilia
  • Hemangioma
  • Risk Factors

    Factors that increase the risk of intussusception include:

        
  • Age: it is the most common cause of obstruction in children 3 months to 6 years old, but the majority are younger than 24 month
  • Season: more common during respiratory and gastrointestinal virus seasons.
  • Sex: male
  • Medical conditions in the list above
  • Symptoms

    The initial symptoms may include:

        
  • Abdominal pain     
  • Usually severe
  • Colicky or cramping
  • Usually comes on suddenly
  • In children, this may be indicated by drawing knees to chest and crying.
  • Vomiting—sometimes yellow or green tinged
  • Stools mixed with mucus and blood—often described as currant jelly
  • Lethargy
  • Additional symptoms include:

        
  • Poor feeding
  • Diarrhea
  • Shock
  • Dehydration
  • Fever
  • Intussusception cuts off the blood supply to the bowel. If this is not treated quickly, it can lead to bowel gangrene. Gangrene can cause tissue in the intestinal wall to die. This may lead to:

        
  • Perforation of the intestinal wall
  • Peritonitis—inflammation of the lining of the abdominal cavity and infection
  • If not treated quickly, peritonitis can lead to death.

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done.

    Bodily fluids may be tested. This can be done with:

        
  • Blood tests
  • Urine tests
  • Images may be taken of your bodily structures. This can be done with:

        
  • Abdominal x-ray
  • Ultrasound
  • CT scan
  • Treatment

    Air Enema

    In many cases, giving an air enema will correct intussusception. Air enema is preferred over water-soluble contrast or barium enema. This is often the preferred treatment when intussusception occurs in infancy. However, the test may cause a perforation to occur in the bowel. An enema should not be done if the bowel is perforated.

    Surgery

    Surgery may be required to release the trapped portion of the bowel and to clear the obstruction. If any bowel tissue has died due to gangrene, that part of the bowel may need to be removed.

    If you are diagnosed with intussusception, follow your doctor's instructions.

    Prevention

    There are no guidelines for preventing intussusception because the cause is unknown. Talk to your doctor about avoiding vaccines that may cause a recurrence.