Intussusception - causes, symptoms, diagnosis, treatment, pathology

Summary

Intussusception is a serious condition where a part of the intestine folds into another, causing an obstruction. Common in infants and young children, it can also affect adults. Often occurring in the ileocecal region, this 'telescoping' can lead to severe symptoms like abdominal pain, vomiting, and 'red currant jelly' stool due to intestinal ischemia. Rapid diagnosis and treatment, including imaging, barium or air enemas, and surgery, are crucial to prevent complications like bowel ischemia and perforation. Early intervention can significantly reduce risks associated with this condition.

Takeaways

• 🔍 Intussusception is an intestinal condition where one part of the intestine folds into another, causing obstruction.
• 👶 It is most common in infants and young children, with about two-thirds occurring in infants under one year of age.
• 📍 The ileocecal region, where the small and large intestines meet, is the usual site of intussusception.
• 🌡️ In adults, it's often caused by an abnormal growth like a polyp or tumor, while in infants, it's commonly due to lymphoid hyperplasia.
• 👶 In children, viral infections like rotavirus or norovirus can cause the lymphoid tissue to enlarge, leading to intussusception.
• 🩺 Intussusception can also be caused by a Meckel’s diverticulum, an abnormal outpouching of gastrointestinal tissue.
• ⚠️ Most cases are idiopathic, meaning they occur without a clear cause, and risk factors include previous occurrences or family history.
• 🤢 Symptoms include intermittent abdominal pain, vomiting, and a hard, sausage-like mass in the abdomen.
• 🩸 Complications can include intestinal ischemia and infarction, leading to 'red currant jelly' stools and potential sepsis.
• 🏥 Diagnosis often requires imaging techniques like ultrasound, X-ray, or CT scan, which can reveal the characteristic 'bull's-eye' sign.
• 🛑 Rapid treatment is crucial, with options including a barium or air enema, or surgery if necessary to prevent serious complications.

Q & A

What is intussusception and how is it commonly described?

Intussusception is a condition where a part of the intestine folds into another section, causing obstruction. It's commonly described as telescoping, similar to how one part of a collapsible telescope retracts into another.

Which age group is most commonly affected by intussusception?

Intussusception most commonly affects infants and young children, with about two-thirds of cases occurring in infants under one year of age.

Where in the intestines does intussusception usually occur?

Intussusception usually occurs in the ileocecal region, where the ileum of the small intestine meets the cecum of the large intestine.

What typically causes intussusception in adults compared to infants?

In adults, intussusception is usually caused by an abnormal growth like a polyp or tumor that serves as a lead point. In infants, it's often caused by lymphoid hyperplasia, where enlarged lymphoid tissue acts as a lead point.

What are Peyer's patches and their role in intussusception?

Peyer's patches are small lymph nodes scattered throughout the intestines, particularly in the ileum. They can enlarge due to a viral infection and sometimes act as a lead point that causes intussusception.

What is a Meckel’s diverticulum and how can it cause intussusception?

A Meckel’s diverticulum is an abnormal outpouching of gastrointestinal tissue from the ileum. It can invert and serve as a lead point, causing the ileum to telescope into the cecum, leading to intussusception.

What are the common symptoms of intussusception in children?

Common symptoms of intussusception in children include intermittent abdominal pain, vomiting, a hard sausage-like mass in the abdomen, and the presence of 'red currant jelly' stool.

What is the significance of 'red currant jelly' stool in intussusception?

'Red currant jelly' stool refers to a mixture of sloughed intestinal mucosal tissue, blood, and mucus in the stool, a sign of ischemic and infarcted bowel tissue in intussusception.

What imaging techniques are used to diagnose intussusception?

Intussusception is often diagnosed using imaging techniques like ultrasound, X-ray, or CT scan, which can reveal a classic bull's-eye pattern and signs of intestinal obstruction.

What are the treatment options for intussusception?

Treatment options for intussusception include a barium or air enema, which can unfold the intussusception, especially in children. If this is unsuccessful or complications arise, surgery may be necessary to free the telescoped intestine and remove any dead tissue.