Intussusception (telescoping intestine)

Description A telescoping of th...

Description

A telescoping of the bowel into itself that can cause a bowel obstruction and decreased blood supply to the portion of the intestine involved. It can affect all ages and both sexes, but is more common in babies 5-10 months of age. Urgent treatment is needed for this disorder to prevent an intestinal perforation, peritonitis and death. The cause of this disorder is unknown.

Symptoms

Bloody mucus-like bowel movement ("currant jelly" stool), fever, low blood pressure, stool mixed with blood and mucus, vomiting, confusion, episodic abdominal pain.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. An abdominal X-ray, air or contrast enema, or abdominal CT scan can all make the diagnosis. The air or contrast enema is considered the diagnostic test of choice for children.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Lipase, X-ray

Other Specific Tests: Air or contrast enema

Specialists:
General Surgery, Gastroenterology, Pediatric Surgery, Pediatric Gastroenterology

Treatment

For adults with intussusception, treatment may not be necessary; close observation may be all that is necessary. Children require reduction of the telescoping bowel. This can frequently be performed by a radiologist with an air or contrast enema. This procedure carries some risk of bowel perforation. If the enema is unsuccessful surgery will usually be required to relieve the intussusception and remove any permanently damaged intestine. Intravenous fluids will be given and the stomach will be decompressed with a naso-gastric tube.