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Intussusception
Overview
Intussusception (in-tuh-suh-SEP-shun) is a serious condition in which part of the intestine slides
into an adjacent part of the intestine. This "telescoping" often blocks food or fluid from passing
through. Intussusception also cuts off the blood supply to the part of the intestine that's affected,
which can lead to a tear in the bowel (perforation), infection and death of bowel tissue.
Intussusception is the most common cause of intestinal obstruction in children younger than 3. The
cause of most cases of intussusception in children is unknown. Though rare in adults, most cases
of adult intussusception are the result of an underlying medical condition, such as a tumor.
In children, the intestines can usually be pushed back into position with an X-ray procedure. In
adults, surgery is often required to correct the problem.
Symptoms
Children
The first sign of intussusception in an otherwise healthy infant may be sudden, loud crying caused
by abdominal pain. Infants who have abdominal pain may pull their knees to their chests when
they cry.
The pain of intussusception comes and goes, usually every 15 to 20 minutes at first. These painful
episodes last longer and happen more often as time passes.
Stool mixed with blood and mucus (sometimes referred to as "currant jelly" stool because of its
appearance)
Vomiting
A lump in the abdomen
Lethargy
Diarrhea
Fever
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Not everyone has all of the symptoms. Some infants have no obvious pain, and some children
don't pass blood or have a lump in the abdomen. Some older children have pain but no other
symptoms.
Adults
Because intussusception is rare in adults and symptoms of the disorder often overlap with the
symptoms of other disorders, it's more challenging to identify. The most common symptom is
abdominal pain that comes and goes. Nausea and vomiting may also occur. People sometimes
have symptoms for weeks before seeking medical attention.
In infants, remember that signs of abdominal pain may include recurrent bouts of pulling the knees
to the chest and crying.
Causes
Your intestine is shaped like a long tube. In intussusception, one part of your intestine — usually
the small intestine — slides inside an adjacent part. This is sometimes called telescoping because
it's similar to the way a collapsible telescope folds together.
In some cases, the telescoping is caused by an abnormal growth in the intestine, such as a polyp
or a tumor (called a lead point). The normal wave-like contractions of the intestine grab this lead
point and pull it and the lining of the intestine into the bowel ahead of it. In most cases, however,
no cause can be identified for intussusception.
Children
In the vast majority of cases of intussusception in children, the cause is unknown. Because
intussusception seems to occur more often in the fall and winter and because many children with
the problem also have flu-like symptoms, some suspect a virus may play a role in the condition.
Sometimes, a lead point can be identified as the cause of the condition — most frequently the lead
point is a Meckel's diverticulum (a pouch in the lining of the small intestine).
Adults
In adults, intussusception is usually the result of a medical condition or procedure, including:
A polyp or tumor
Scar-like tissue in the intestine (adhesions)
Weight-loss surgery (gastric bypass) or other surgery on the intestinal tract
Inflammation due to diseases such as Crohn's disease
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Risk factors
Risk factors for intussusception include:
Age. Children — especially young children — are much more likely to develop intussusception
than adults are. It's the most common cause of bowel obstruction in children between the ages
of 6 months and 3 years.
Sex. Intussusception more often affects boys.
Abnormal intestinal formation at birth. Intestinal malrotation is a condition in which the
intestine doesn't develop or rotate correctly, and it increases the risk for intussusception.
A prior history of intussusception. Once you've had intussusception, you're at increased risk
of developing it again.
A family history. Siblings of someone who's had an intussusception are at a much higher risk
of the disorder.
Complications
Intussusception can cut off the blood supply to the affected portion of the intestine. If left untreated,
lack of blood causes tissue of the intestinal wall to die. Tissue death can lead to a tear (perforation)
in the intestinal wall, which can cause an infection of the lining of the abdominal cavity (peritonitis).
Peritonitis is a life-threatening condition that requires immediate medical attention. Signs and
symptoms of peritonitis include:
Abdominal pain
Abdominal swelling
Fever
Peritonitis may cause your child to go into shock. Signs and symptoms of shock include:
A child who is in shock may be conscious or unconscious. If you suspect your child is in shock,
seek emergency medical care right away.
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