Intussusception (cont.)
How is intussusception diagnosed?
The history of abdominal pain and vomiting as described above, may suggest
the diagnosis of intussusception. Additionally, the examining doctor may feel
an abdominal "sausage-shaped" mass (the intussusception itself) or upon
auscultation with a stethoscope, may hear diminished or absent bowel sounds. Lab
tests are usually not helpful, although plain abdominal X-rays can reveal signs
of an intestinal obstruction, including air-fluid levels, decreased gas, and
unexplained masses, usually seen in the right lower quadrant of the abdomen.
Ultrasound and
CT scans are generally not required to make the diagnosis.
A barium, water-soluble contrast or air enema is
considered both diagnostic and therapeutic in the management of intussusception.
This radiologic procedure
involves the introduction of the contrast into the lower intestine. If an
intussusception is present, it will be seen during the imaging. Often just the
introduction of the contrast will reduce the telescoped bowel to its normal
position and shape. In these cases there is a high risk of for
re-intussusception in the first 24 hours following the enema.
Is it necessary to operate when there is intussusception?
The treatment of intussusception may or may not require
surgery. In some cases, the intestinal obstruction can be reversed with an
enema. The enema carries a risk of intestinal rupture and cannot be done if the
bowel has already perforated. The procedure also requires the availability of a
surgeon, in case
the patient's bowel ruptures or the intussusception cannot be reduced.
If the intestinal obstruction cannot be reversed by a
barium enema, surgery
is necessary to reverse the intussusception and relieve the obstruction. If a
portion of the intestine has become gangrenous, it must be removed. After
surgery, intravenous feeding and fluids are continued until normal bowel
movements resume.
Next: What is the prognosis (outlook) for patients with intussusception? »
- Barium Enema - Read about the barium enema procedure used as a diagnostic tool to diagnose conditions such as diverticulitis, colon polyps, colonic abscesses, cancer, and Hirschsprung disease.
- Abdominal Pain - Learn about abdominal pain (pain in the stomach / abdomen) including causes, symptoms, how abdominal pain is diagnosed, and how abdominal pain is treated.
- Rectal Bleeding - Rectal bleeding can be a sign of several different conditions including hemorrhoids, anal fisure, colitis, and more.
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