Intussusception: Treatment, symptoms, advice and help
Intussusception is a condition in which a portion of the intestine tunnels into an adjacent segment. It is usually found in children and is a medical emergency condition.
Intussusception: Incidence, age and sex
Intussusception is more common in children with peak incidence in the age group 3-9 months. It may be associated with illness such as gastroenteritis or urinary infection in about 30% of individuals. It is more common in male children.
Signs and symptoms of intussusception: Diagnosis
Intussusception results in sudden onset of screaming (due to intense pain) associated with drawing up of legs. The attack lasts for few minutes, recurs every 15 minutes and becomes progressively severe. During the attacks of pain, the child has a pale face while between attacks, the child is listless and lethargic. Vomiting becomes conspicuous with time. The stool may be stained with blood and mucus and characteristically called “redcurrant” jelly stool.
The clinical examination should be done between the episodes of pain without disturbing the child. A lump that hardens on palpation may be found in 50 – 60% of the cases. On rectal examination, blood stained mucus is found on the finger. Other imaging tests like plain x-ray abdomen or barium enema may need to be done in some cases to establish the diagnosis of intussusception and subsequent intestinal obstruction.
Causes and prevention of intussusception
The exact cause of intussusception is not clear. However certain conditions like appendicitis, intestinal tumours or polyps (benign growth in intestine) or viral infections have shown increased incidence of intussusception. Other rare triggering factors include Meckel’s diverticulum, Henoch-Schonlein purpura in children and submucosal lipoma in adults. There are no specific preventive measures.
Intussusception, if left untreated, may result in fatal consequences like dehydration and shock. The affected individual may experience continuous pain accompanied with profound vomiting. Ultimately, death may also occur from intestinal obstruction or secondary bacterial infection of intestines.
The first and foremost step is to stabilize the individual and provide supportive care. Management of dehydration is done by providing adequate amount of fluids intravenously. In some individuals, air or contrast enema may help in managing the condition. This procedure involves insertion of a flexible tube through the rectum into the intestines into which air is pushed to correct the intussusception. In unsuccessful attempts, surgical approach is the only line of management.