Intussusception (medical disorder): Difference between revisions

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'''Intussusception''' is a medical condition in which a part of the [[intestine]] [[invaginate|folds into]] the section immediately ahead of it.<ref name=Mar2017/> It typically involves the [[small bowel]] and less commonly the [[large bowel]].<ref name=Mar2017/> Symptoms include abdominal pain which may come and go, vomiting, abdominal bloating, and bloody stool.<ref name=Mar2017/> It often results in a [[small bowel obstruction]].<ref name=Mar2017/> Other complications may include [[peritonitis]] or [[bowel perforation]].<ref name=Mar2017>{{cite journal|last1=Marsicovetere|first1=P|last2=Ivatury|first2=SJ|last3=White|first3=B|last4=Holubar|first4=SD|title=Intestinal Intussusception: Etiology, Diagnosis, and Treatment.|journal=Clinics in colon and rectal surgery|date=February 2017|volume=30|issue=1|pages=30–39|pmid=28144210|doi=10.1055/s-0036-1593429|pmc=5179276}}</ref>
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The cause in children is typically unknown; in adults a ''lead point'' is sometimes present.<ref name=Mar2017/> Risk factors in children include certain infections, diseases like [[cystic fibrosis]], and [[intestinal polyp]]s.<ref name=Mar2017/> Risk factors in adults include [[endometriosis]], [[bowel adhesions]], and [[intestinal tumors]].<ref name=Mar2017/> Diagnosis is often supported by [[medical imaging]].<ref name=Mar2017/> In children, [[ultrasound]] is preferred while in adults a [[CT scan]] is preferred.<ref name=Mar2017/>
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Intussusception is an emergency requiring rapid treatment.<ref name=Mar2017/> Treatment in children is typically by an [[enema]] with surgery used if this is not successful.<ref name=Mar2017/> [[Dexamethasone]] may decrease the risk of another episode.<ref name=Gl2017>{{cite journal|last1=Gluckman|first1=S|last2=Karpelowsky|first2=J|last3=Webster|first3=AC|last4=McGee|first4=RG|title=Management for intussusception in children.|journal=The Cochrane Database of Systematic Reviews|date=1 June 2017|volume=6|pages=CD006476|doi=10.1002/14651858.CD006476.pub3|pmid=28567798}}</ref> In adults, [[bowel resection|surgical removal of part of the bowel]] is more often required.<ref name=Mar2017/> Intussusception occurs more commonly in children than adults.<ref name=Mar2017/> In children, males are more often affected than females.<ref name=Mar2017/> The usual age of occurrence is six to eighteen months old.<ref name=Mar2017/>
==Signs and symptoms==
== Cause==
Causes of intussusception are not clearly established or understood. About 90% of cases of intussusception in children arise from an unknown cause.<ref name="Mar2017">{{cite journal|last1=Marsicovetere|first1=P|last2=Ivatury|first2=SJ|last3=White|first3=B|last4=Holubar|first4=SD|date=February 2017|title=Intestinal Intussusception: Etiology, Diagnosis, and Treatment.|journal=Clinics in colon and rectal surgery|volume=30|issue=1|pages=30–39|doi=10.1055/s-0036-1593429|pmc=5179276|pmid=28144210}}</ref> They can include infections, anatomical factors, and altered motility.
* [[Meckel's diverticulum]]