Summary about Disease
Intussusception is a serious condition in which a part of the intestine slides into another part, much like a telescope collapsing. This "telescoping" can block the intestine and cut off blood supply to the affected area. It is most common in infants and young children. If left untreated, intussusception can lead to serious complications, including bowel damage, infection, and death.
Symptoms
The symptoms of intussusception can vary, but often include:
Sudden, loud crying that comes and goes every 15 to 20 minutes, with the child pulling their knees to their chest when crying.
Vomiting (may be bile-stained).
Stool mixed with blood and mucus (often described as "currant jelly" stool).
A lump in the abdomen.
Lethargy or weakness.
Diarrhea.
Fever.
In some cases, the child may appear normal between episodes of pain.
Causes
The exact cause of intussusception is often unknown. However, some factors that may increase the risk include:
Recent viral infection (like a cold or the flu).
Enlarged lymph nodes in the intestine.
Polyps or tumors in the intestine (rare, especially in children).
Meckel's diverticulum (a small pouch in the small intestine).
In older children, it can be associated with conditions like Henoch-Schönlein purpura or cystic fibrosis.
Medicine Used
Intussusception is generally not treated with medicine alone. The primary treatment involves non-surgical reduction, usually with an air enema or a contrast enema (barium or water-soluble contrast). An enema uses air or liquid to apply pressure to the intestine to push the telescoped portion back into its original position. If the enema is unsuccessful or if the intestine is severely damaged, surgery may be required to manually reduce the intussusception and remove any damaged tissue. Pain management medication is typically administered both pre and post procedure. Antibiotics are prescribed if peritonitis or sepsis develops.
Is Communicable
Intussusception itself is not communicable. It is not caused by a contagious agent like a virus or bacteria. However, if a viral infection is a contributing factor, the viral infection itself might be contagious.
Precautions
Because the exact cause is often unknown, there are few specific precautions to prevent intussusception. General measures to maintain good health, such as practicing good hygiene to prevent infections, may be helpful. Early recognition of the symptoms and prompt medical attention are crucial.
How long does an outbreak last?
Intussusception itself isn't an "outbreak" like a contagious disease. It's an event where the intestine telescopes. Without treatment, the condition worsens rapidly. Symptoms typically progress over 12-72 hours, with the affected portion of the intestine eventually developing vascular compromise leading to bowel necrosis and perforation.
How is it diagnosed?
Intussusception is diagnosed based on a combination of factors:
Physical exam: A doctor will examine the child's abdomen for a lump or tenderness.
Medical history: The doctor will ask about the child's symptoms and medical history.
Imaging studies:
Ultrasound: This is often the first imaging test used. It can often show the "target sign" or "doughnut sign," which is characteristic of intussusception.
Air enema or contrast enema: Not only can this be diagnostic, but it is also often therapeutic, as it may reduce the intussusception.
X-ray: May be used if an enema is not possible or to look for complications like bowel perforation.
Timeline of Symptoms
Early: Sudden, intermittent abdominal pain with loud crying, pulling knees to chest. Vomiting may start.
Intermediate: Pain episodes become more frequent and severe. Vomiting continues and may become bile-stained. Stools may become bloody and mucoid ("currant jelly"). The child may become lethargic.
Late: Fever, dehydration, shock, and peritonitis (inflammation of the abdominal lining) can develop. The child may become less responsive. Without treatment, this can lead to bowel necrosis, perforation, sepsis, and death.
Important Considerations
Intussusception is a medical emergency. Prompt diagnosis and treatment are crucial to prevent serious complications.
Even after successful reduction (either by enema or surgery), there is a risk of recurrence.
Parents should be educated about the signs and symptoms of intussusception and instructed to seek immediate medical attention if they suspect their child may have the condition.
Dehydration from vomiting and decreased oral intake is common and needs to be addressed with intravenous fluids.
The success rate of non-surgical reduction is high, but surgery may be necessary if the enema is unsuccessful, if there is bowel perforation, or if the child is very ill.