Intussusception (cont.)
Is intussusception an urgent problem?
Intussusception is an emergency and requires immediate attention
Who is at greatest risk for intussusception?
Most cases of intussusception occur in children between 5 months and 1 year
of age. Boys develop the condition two times more often than girls.
Intussusception can also occur in adults and older children, although it is
uncommon.
What causes intussusception?
The causes of intussusception are not fully known. Most cases in young
children are idiopathic, (meaning the cause is unknown), although some
viral and
bacterial infections of the intestine may possibly contribute to intussusception
in infancy.
Intussusception is very rare in older children and adults. In this
population, the causes are believed to be due to
polyps or tumors, which are
often referred to as the "lead point" of the intussusception.
Why is rapid diagnosis of intussusception important?
Early diagnosis and treatment of intussusception is
essential in order to prevent injury to the intestine and the associated sequelae, including
surgical removal of the bowel, sepsis, and even death.
What are the symptoms of intussusception?
Most describe the symptoms of intussusception as a triad
of colicky abdominal pain, bilious
vomiting, and "currant
jelly" stool.
The primary symptom of intussusception is described as
intermittent crampy abdominal pain. This is often called "colicky pain." Intussusception in an
infant usually starts with
the infant suddenly crying very loudly, as if in great pain. The infant
intermittently draws the knees up to the chest while crying. This reaction is
caused by the abdominal pain which recurs frequently and increases in intensity
and duration. These intermittent painful episodes are believed to be caused by
the telescoping of the bowel and resultant compression of blood vessels and
nerves.
In addition to the abdominal pain, most children will also have episodes of
vomiting associated with the pain. This vomiting is usually not associated with
eating and may be bilious (yellow-green colored)
Some affected individuals who do not seek early medical attention may pass
"currant jelly stool". This is stool that is bloody and mucousy and may be a
sign that the affected bowel has lost its blood supply and that the bowel may be
necrotic (non-viable).
As the condition progresses, the infant becomes may become weaker and develop
additional symptoms, including those associated with shock, such as paleness,
lethargy, and even
fever, though these are not an integral part of the
associated "triad."
Thankfully, most cases are diagnosed early, and some studies describe the
development of the bloody stools as occurring in only one-third of the cases
diagnosed.
Next: How is intussusception diagnosed? »
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