Intussusception: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Intussusception is a serious disorder that develops when a portion of the intestine slides into another portion of the gut. It frequently becomes difficult for food or drink to get through due to the telescoping motion. Additionally, intussusception stops the blood supply to the intestine's affected portion. This might result in an infection, a rupture or perforation in the gut, or the death of intestinal tissue.

Intussusception is an uncommon but possibly dangerous condition that causes one intestinal segment to move within another segment.

Intussusception is the most common reason for intestinal obstruction in children under the age of three. The majority of intussusception cases in children have no known cause. Despite the rarity of adult intussusception, the majority of these occurrences are caused by an underlying disease, such as a tumour.

Causes Of Intussusception 

Your intestine is shaped like a long tube. During intussusception, a section of your intestine typically the small intestine moves within another portion. This is usually referred to as telescoping because of how it slides together like a folding telescope.

In some adult patients, a lead point, also known as a polyp or tumour, can develop in the colon and cause telescoping. The typical wavelike contractions of the intestine draw this lead point and the lining of the gut into the intestines in front of it. However, the cause of intussusception is often unknown.

Children

In circumstances involving children's intussusception, the cause is frequently unknown. Intussusception tends to occur more commonly in the autumn and winter. In addition, as many affected youngsters also show flu-like symptoms, some people think a virus may be responsible for the condition. A lead point, usually a pouch in the lining of the small intestine (Meckel's diverticulum), can occasionally be identified as the condition's source.

Adults

Adult intussusception frequently develops from a condition or medication like:

• A polyp or tumour.
• Intestinal adhesions are a form of tissue that resembles scar tissue.
• Digestive system surgery or weight-loss procedures like gastric bypass.
• Intestine bulge caused by diseases like Crohn's

Symptoms Of Intussusception 

In children, the intestines can usually be brought back into position with a little operation. In adults, surgery is frequently required to correct the problem. A healthy child who abruptly and loudly cries out because their stomach hurts may otherwise be in good condition. Babies in agony may pull their legs up to their chests while they scream.

Pain associated with intussusception initially comes and goes, usually every 15 to 20 minutes. These agonising bouts grow worse and more frequent as time passes.

A few more symptoms and indicators of intussusception are:

• Mucous and blood in the stool; due to its appearance, it is also known as currant jelly stool.
• Vomiting.
• Distended stomach.
• Weakness or fatigue.
• Diarrhoea.

Not everyone exhibits every symptom. Some children seem to have no pain. Some children experience lumps in their stomachs or are unable to urinate. Furthermore, some older children only have pain and no other symptoms.

Intussusception is rare in adults. Additionally, it is more challenging to identify because the disorder's symptoms commonly mimic those of other illnesses. The most frequent symptom is sporadic stomach pain. Additionally, nausea and vomiting are possibilities. Sometimes people wait weeks after experiencing symptoms before seeking medical attention.

Risk Factors of Intussusception 

Risk factors for intussusception include:

• Age: Particularly young children are far more likely than adults to experience intussusception. It is the most common cause of intestinal blockage in kids between the ages of 6 months and 3 years.
• Sex: Intussusception typically affects boys more frequently.
• Aberrant gastrointestinal growth during birth: Intestinal malrotation is a condition when the intestine does not develop or rotate appropriately. This particular set of circumstances increases the chance of intussusception. Certain disorders, like CF, can raise the risk of intussusception. CF. Cystic fibrosis.
• Henoch-Schonlein purpura, commonly known as IgA vasculitis.
• Crohn's disease.
• Celiac disease.

Diagnosis Of Intussusception 

The healthcare provider will start by learning about the symptoms of the issue from you or your child. The caretaker might feel a sausage-shaped bulge in the patient's stomach. To confirm the diagnosis, your healthcare provider could give the following instructions:

Another method of visualising the abdomen. An ultrasound, X-ray, or computerised tomography (CT) scan can identify an intestinal obstruction caused by intussusception. A "bull's-eye," which represents the intestine coiling within the gut, is typically visible in imaging. The results of abdominal imaging can also show whether the intestine has been torn (perforated).

Treatment Of Intussusception 

Medical emergencies are frequently used to treat intussusception. A part of the intestine that has died because of a lack of blood must need rapid medical care to prevent significant dehydration, shock, and infection.

There are numerous ways to cure intussusception.

• Water-soluble contrast or air enema: This is a technique that is both diagnostic and therapeutic. If an enema is successful, extra therapy is typically not needed. 90% of the time, this technique is sufficient to successfully treat a child's intussusception. Rip (perforated) intestines are ineligible for this treatment.

Up to 20% of the time, intussusception will return, necessitating repeated treatment. Even if an enema is intended as part of the treatment, it is crucial to see a surgeon. This is because there is a very small chance that this treatment will result in a bowel rupture or rip.

• Surgery: If the intestine is damaged, an enema is ineffective, or a lead point is to blame, surgery is necessary. A piece of the intestine that is clogged will be released by the surgeon, who will also remove the obstruction and any dead intestinal tissue if necessary. Surgery is the most common kind of care for adults and seriously ill patients.  intussusception may occasionally be transient and disappear.

Complications Of Intussusception 

The damaged area of the intestine may experience an interruption in blood flow due to intussusception. Lack of blood can kill intestinal wall tissue if left unchecked. A perforation, often known as a tear in the intestinal wall, can result from tissue death. This may result in peritonitis, an infection of the lining of the abdominal cavity.

A life-threatening condition called peritonitis necessitates urgent medical care. Peritonitis signs and symptoms include:

• Stomach ache.
• Swelling around the belly.
• Fever.
• Vomiting.

Your child can experience shock as a result of peritonitis. Shock symptoms include:

• Skin that is cold and clammy and may be grey or pallid.
• A quick and feeble pulse.
• Breathing can be either very quickly or slowly and deeply.
• Agitation or anxiety.
• Extreme lassitude.

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