Causes, symptoms and treatment of intestinal obstruction

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Intussusception is a type of intestinal obstruction in which part of the intestine sits into another part, such as a telescope. 
Although it can occur anywhere in the gastrointestinal tract, it usually occurs where the small and large intestines meet.

Ingestion (in-tuh-suh-SEP-shun) is a serious disease in which part of the intestine slips into the adjacent part of the intestine. This telescope operation often prevents food or liquids from passing through. Intussusception also cuts off blood flow to the affected part of the intestine. This can lead to rupture of the intestine (perforation), infection and death of intestinal tissue.

Dislocation is the most common cause of intestinal obstruction in children under 3 years of age. The cause of most cases of intussusception in children is unknown. Although intussusception is rare in adults, most cases of adult intussusception are the result of an underlying disease such as a tumor.

In children, the bowels can usually be restored in a minor way. In adults, surgery is often needed to correct the problem.

Symptoms of intussusception 

SYMPTOMS OF INTUSSUSCEPTION

SYMPTOMS OF INTUSSUSCEPTION IN CHILDREN

The first sign of intussusception in a healthy baby may be a sudden, loud cry from abdominal pain. Babies with abdominal pain may pull their knees toward their chest when crying.

The pain of intussusception usually comes and goes every 15 to 20 minutes. Over time, these painful periods become longer and more frequent.

Other common signs and symptoms of intussusception include:

Stools mixed with blood and mucus  

– Vomit

– A lump in the abdomen

Weakness or lack of energy

– Diarrhea

Not everyone has the symptoms. Some babies have no obvious pain and some babies do not bleed or have a lump in the abdomen. Some older children have pain but no other symptoms.

SYMPTOMS OF INTUSSUSCEPTION IN ADULTS

Because intussusception is rare in adults and the symptoms of this disorder often overlap with the symptoms of other disorders, it is more challenging to identify. The most common symptom is abdominal pain that comes and goes. Nausea and vomiting may also occur. Sometimes people have symptoms for weeks before seeing a doctor.

WHEN TO SEE A DOCTOR?

Intussusception requires emergency medical care. If you or your child develops any of the above symptoms, seek medical attention immediately.

In infants, keep in mind that symptoms of abdominal pain may include pulling the knee toward the chest and crying.

Causes of intussusception or intestinal obstruction 

CAUSES OF INTUSSUSCEPTION

Your intestine is in the shape of a long tube. In intussusception, part of your bowel (usually the small intestine) slides into the adjacent part. It is sometimes called a telescope because it is similar to how a folding telescope slides into each other.

In some cases in adults, the telescope is caused by abnormal growth in the gut, such as a polyp or tumor (called a lead spot). Normal wave-like contractions of the intestine capture this lead point and push it and the intestinal lining forward into the intestine. In most cases, however, no cause for intussusception can be identified.

In the vast majority of cases of intussusception in children, the cause is unknown. Because intussusception is more likely to occur in the fall and winter, and because many children with the condition have flu-like symptoms, some suspect that the virus may be involved. Occasionally, a lead spot can be identified as the cause of the disease, often the lead spot is a sac in the lining of the small intestine (Meckel’s diverticulum).

In adults, intussusception is usually the result of a medical condition or procedure, including:

– Polyp or tumor

Scar-like tissue in the intestine (adhesion)

Weight loss surgery (gastric bypass) or other surgeries on the intestinal tract

Inflammation caused by diseases such as Crohn’s disease

Babies are more at risk for intussusception

RISK FACTORS FOR INTUSSUSCEPTION 

Risk factors for intussusception include:

Age: Children, especially young children, are much more prone to intussusception than adults. This is the most common cause of intestinal obstruction in children between the ages of 6 months and 3 years.

Gender: Ingestion mostly affects boys.

Abnormal bowel formation at birth: Bad bowel rotation is a condition in which the bowel does not grow or rotate properly and increases the risk of intussusception.

Specific conditions of some disorders: such as cystic fibrosis, Enoch Schonlin purpura (also known as IgA vasculitis), Crohn’s disease and celiac disease, can increase the risk of intussusception.

COMPLICATIONS OF INTUSSUSCEPTION

Intussusception can cut off blood flow to the affected part of the intestine. If left untreated, a lack of blood can kill the intestinal wall tissue. Tissue death can lead to rupture (perforation) of the intestinal wall, which can lead to infection of the lining of the abdominal cavity (peritonitis).

Peritonitis is a life-threatening disease that requires immediate medical attention. Signs and symptoms of peritonitis include:

– stomach ache

– Swelling of the abdomen

– Then

– Vomit

Peritonitis may shock your baby. Signs and symptoms of shock include:

Cold and delicate skin that may be pale or gray.

Weak and fast pulse

Abnormal breathing, which may be slow and shallow or very fast.

Anxiety or restlessness

– Deep lethargy

A child in shock may be conscious or unconscious. If you suspect your child is in shock, seek emergency medical care immediately.

Ways to diagnose and treat intussusception 

DIAGNOSIS OF INTUSSUSCEPTION

Your doctor or your child will start by getting a history of problem symptoms. He may be able to feel a sausage-shaped mass in his abdomen. Your doctor may order an ultrasound to confirm the diagnosis.

Ultrasound, X-rays, or computed tomography (CT) scans may show intestinal obstruction due to intussusception. Abdominal imaging can also show if the bowel is torn.

TREATMENT OF INTUSSUSCEPTION 

Treatment of intussusception usually occurs as a medical emergency. Emergency medical care is needed to prevent severe dehydration and shock, as well as to prevent an infection that can occur when a part of the intestine dies due to anemia.

Treatment options for intussusception may include:

Water-soluble contrast or air purification: This is both a diagnostic method and a treatment. If the enema is effective, no further treatment is usually needed. This treatment can actually cure angina in children 90% of the time and no further treatment is needed. This method cannot be used if the intestine is torn (perforated).

Intussusception recurrs up to 20% of times and treatment should be repeated. It is important to consult a surgeon even if treatment with enema is planned. This is due to the low risk of rupture or rupture of the bowel with this treatment.

Surgery: Surgery is necessary if the bowel is torn, if the enema fails to correct the problem, or if the lead spot is the cause. The surgeon releases the trapped part of the intestine, removes the obstruction, and removes dead bowel tissue if necessary. Surgery is the main treatment for adults and people who are seriously ill.

In some cases, intussusception may be temporary and go away without treatment.

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