Intussusception

Telescoping (prolapse) of a portion of the intestine within another immediately adjacent portion of intestine. This decreases the supply of blood to the affected part of the intestine, and frequently leads to intestinal obstruction. The pressure created by the two walls of the intestine pressing together causes inflammation, swelling, and reduces the blood flow. Death of bowel tissue can occur, with significant bleeding, perforation, abdominal infection, and shock occurring very rapidly. Most cases of intussusception occur in children between five months and one year of age. Boys are affected three times more often than girls. The cause of intussusception is not known, although viral infections of the intestine may contribute to intussusception in infancy. In older children or adults, the presence of polyps or a tumor may trigger the intussusception. Early diagnosis is very important. Symptoms begin with sudden, loud crying in an infant, with the baby drawing the knees up to the chest while crying. This reaction is caused by abdominal cramping. The pain and crying is intermittent, but recurs frequently, and increases in intensity and duration. Fever is common. As the condition progresses, the infant becomes weak and then shows signs of shock, including pale color, lethargy, and sweating. About half of afflicted infants pass a bloody, mucousy ("currant jelly") stool. On examining the abdomen, the doctor may feel a mass. Abdominal X-rays may suggest intestinal obstruction, but a barium enema is needed to show the characteristic telescoping of the bowel. Treatment may or may not require surgery. In some cases, the intestinal obstruction can be reduced with a barium enema by a radiologist. (There is a risk of bowel perforation with this procedure, so it cannot be performed if perforation has already occurred). If the obstruction cannot be reduced by a barium enema, surgery is needed to reduce the intussusception, relieve the obstruction, and remove any dead tissue. Intravenous feeding and fluid are continued until a normal bowel movement has passed. Although intussusception is life-threatening, the outlook is good with early treatment.

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1. The taking up or receiving of one part within another, especially the enfolding of one segment of the intestine within another. SEE ALSO: introversion, invagination. 2. Often, specifically, the process of incorporation of new material in the growth of the cell wall. SYN: introsusception. [L. intus, within, + sus-cipio, to take up, fr. sub + capio, to take]

- colic i. the ensheathing of one portion of the colon into another.

- double i. a second i. that involves the bowel above the first; the first i. is followed by contraction of the bowel wall around it, and the solid mass so formed is enveloped by the proximal portion of the bowel and is thus the cause of the second i..

- ileal i. i. in which one portion of the ileum is ensheathed in another portion of the same division of the bowel.

- ileocecal i. i. in which the lower segment of the ileum passes through the valve of the colon into the cecum.

- ileocolic i. i. in which the lower portion of the ileum with the valve of the cecum passes into the ascending colon.

- jejunogastric i. a rare complication following gastrojejunostomy in which the afferent or the efferent loop of bowel invaginates into the stomach.

- retrograde i. the invagination of a lower segment of the bowel into one just above.

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in·tus·sus·cep·tion -'sep-shən n

1) INVAGINATION esp the slipping of a length of intestine into an adjacent portion usu. producing obstruction

2) the deposition of new particles of formative material among those already embodied in a tissue or structure (as in the growth of living organisms) compare ACCRETION, APPOSITION (1)

in·tus·sus·cep·tive -'sep-tiv adj

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n.

the telescoping (invagination) of one part of the bowel into another: most common in young children under the age of four. As the contents of the intestine are pushed onwards by muscular contraction more and more intestine is dragged into the invaginating portion, resulting in obstruction. Symptoms include intermittent screaming and pallor, vomiting, and the passing of red jelly with the stools; if the condition does not receive prompt surgical treatment, shock from gangrene of the bowel may result. A barium or Gastrografin enema may confirm the diagnosis and in many cases may relieve the intussusception.

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in·tus·sus·cep·tion (in″tə-sə-sepґshən) [L. intus within + suscipere to receive] 1. a receiving within. 2. prolapse of one part of the intestine into the lumen of an immediately adjoining part. It is most common in infants, and in adults it is often associated with a neoplasm. Symptoms include partial obstruction, a palpable abdominal mass, and abdominal pain with cramping.