By: Erin C. Rauch
is a telescoping of one part of the intestine into another.
Peristalsis forces the proximal portion of the bowel back into itself.
obstruction will occur at this point. This can lead to a decreased
blood supply to the affected portion of the bowel, which can cause death
of the bowel tissue. This condition occurs most often in children,
and is most common at the ileocecal valve. Early diagnosis is critical
in order to save the bowel and the infant. The mortality rate of
children with intussusception is less than 1% (Eisenberg & Dennie,
The specific cause of intussusception is
unknown. It is possible that is caused by viral infections (Adam.com,
1999). In adults, intussusception can be caused by a neoplasm (tumor),
celiac disease or diarrheal diseases. It can also be caused by blunt abdominal
trauma. (Warshauer & Lee, 1999). It occurs most often in children
who are between the ages of 5 months and one year. It occurs in boys
three times as often as it does in girls (Adam.com, 1999).
The pressure of the two walls of the intestine pressing against each other can cause inflammation & swelling. This can lead to a decreased blood flow to that area. As previously mentioned, this can cause that portion of the bowel to die. This in turn can cause bleeding, perforation, and infection (Adam.com, 1999).
In infants, the first sign of intussusception
is pained crying. This is caused by abdominal pain. Other symptoms
include abdominal tenderness, dehydration, vomiting, fever, restlessness,
diarrhea and bloody stool. The child can even go into shock, turn
pale, and sweat (Gorenstein et al., 1998).
A plain abdominal x-ray could show a bowel obstruction that can be caused by this condition. A barium enema can show the telescoping of the bowel. Radiographically, a coiled-spring appearance of trapped barium will be seen (Eisenberg & Dennie, 1995).
In some cases, the pressure of the barium going through the bowel, during the enema, can cause it to un-telescope itself, curing the patient. However, this increases the risk of bowel perforation. Insufflation of air into the bowel, has also been an effective technique in children. In adults, a repeat barium enema should be done after treatment in order to determine the original underlying cause (Eisenberg & Dennie, 1995).
If either barium or air is unsuccessful then
surgery is needed. Usually the bowel can be saved. If there
is dying tissue present, then it is surgically removed and the bowel will
be resected. Intravenous feeding will be done until a normal
bowel movement has passed (Adam.com, 1999).
The outcome for infants is good if they were treated early. Older children or adults will need to further investigate the original cause of their intussusception in order to prevent another occurrence or other health problems (Adam.com, 1999).
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Eisenberg, R., & C. Dennie (1995). Comprehensive Radiographic Pathology (2nd ed.). St. Louis: Mosby.
Gorenstein, A., Raucher, A., Serour,
F., Witzling, M., & Katz, R. (1998). Intussusception in Children: Reduction
Repeated, Delayed Air Enema. Radiology, 206, 721-724.
Warshauer, D., & Lee, J. (1999).
Adult Intussusception Detected at CT or MRI Imaging: Clinical-Imaging Correlation.
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