Intussusception (medical disorder): Difference between revisions

Alter: journal, template type. Add: doi, journal, s2cid, pmc, pmid, author pars. 1-1. Removed URL that duplicated unique identifier. Removed parameters. Some additions/deletions were actually parameter name changes. | You can use this bot yourself. Report bugs here. | Suggested by SemperIocundus | via #UCB_webform
(uncapitalized N in In)
(Alter: journal, template type. Add: doi, journal, s2cid, pmc, pmid, author pars. 1-1. Removed URL that duplicated unique identifier. Removed parameters. Some additions/deletions were actually parameter name changes. | You can use this bot yourself. Report bugs here. | Suggested by SemperIocundus | via #UCB_webform)
}}
<!-- Definition and symptoms -->
'''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 colonColon and rectalRectal surgerySurgery|date=February 2017|volume=30|issue=1|pages=30–39|pmid=28144210|doi=10.1055/s-0036-1593429|pmc=5179276}}</ref>
 
<!-- Cause and diagnosis -->
* [[Idiopathic]]
 
While an earlier version of the [[rotavirus vaccine]] was linked to intussusception, the current versions is not.<ref name=Lu2019>{{cite journal |last1=Lu |first1=Hai-Ling |last2=Ding |first2=Ying |last3=Goyal |first3=Hemant |last4=Xu |first4=Hua-Guo |title=Association Between Rotavirus Vaccination and Risk of Intussusception Among Neonates and Infants |journal=JAMA Network Open |date=4 October 2019 |volume=2 |issue=10 |pages=e1912458 |doi=10.1001/jamanetworkopen.2019.12458|pmid=31584679 |pmc=6784808 |doi-access=free }}</ref>
 
==Pathophysiology==
]]
[[File:Intussusception on ultrasound.jpg|thumb|An [[ultrasound]] shows a target sign—characteristic for intussusception]]
An intussusception is often suspected based on history and physical exam, including observation of [[Dance's sign]]. A digital [[rectal examination]] is particularly helpful in children, as part of the intussusceptum may be felt by the finger. A definite diagnosis often requires confirmation by diagnostic imaging modalities. [[Ultrasound]] is the imaging modality of choice for diagnosis and exclusion of intussusception, due to its high accuracy and lack of radiation. The appearance of target sign (also called "doughnut sign" on a sonograph, usually around 3&nbsp;cm in diameter, confirms the diagnosis. The image seen on transverse [[Medical ultrasonography|sonography]] or [[Computed tomography of the abdomen and pelvis|computed tomography]] is that of a doughnut shape, created by the [[hyperechogenicity|hyperechoic]] central core of [[Human gastrointestinal tract#Lower gastrointestinal tract|bowel]] and [[mesentery]] surrounded by the [[hypoechogenicity|hypoechoic]] outer [[edema]]tous bowel.<ref name=Park/> In longitudinal imaging, intussusception resembles a sandwich.<ref name=Park>{{cite journal |vauthors=Park NH, Park SI, Park CS, Lee EJ, Kim MS, Ryu JA, Bae JM |title=Ultrasonographic findings of small bowel intussusception, focusing on differentiation from ileocolic intussusception|journal=Br J Radiol|date =2007|volume=80|issue=958|pages=798–802 |pmid=17875595 |issn=0007-1285|doi=10.1259/bjr/61246651 |url= }}</ref> It is also called "pseudokidney" sign because hyperechoic tubular centre is covered by a hypoechoic rim producing a kidney-like appearance.<ref>{{Cite journal |lastlast1=Charles |firstfirst1=T. |last2=Penninga |first2=L. |last3=Reurings |first3=J. C. |last4=Berry |first4=M. C. J. |date=January 2015 |title=Intussusception in Children: A Clinical Review |url=http://www.tandfonline.com/doi/full/10.1080/00015458.2015.11681124 |journal=Acta Chirurgica Belgica |language=en |volume=115 |issue=5 |pages=327–333 |doi=10.1080/00015458.2015.11681124 |pmid=26559998 |s2cid=21843245 |issn=0001-5458}}</ref>
 
An [[x-ray]] of the abdomen may be indicated to check for intestinal obstruction or free intraperitoneal gas. The latter finding implies that bowel perforation has already occurred. Some institutions use [[air enema]] for diagnosis, as the same procedure can be used for treatment.<ref>{{cite webjournal |author=C Surendranath Singh |author2=M.l. Prakash |url=http://www.webmedcentral.com/article_view/2052 |title=Adult Intussception : A Case Report |journal=Webmedcentral |publisher=Webmed Central |doi=10.9754/journal.wmc.2011.002052 |issn=2046-1690 |date=28 Jul 2011 |access-date=June 5, 2016 |url-status=live |archiveurl=https://web.archive.org/web/20160610194158/http://www.webmedcentral.com/article_view/2052 |archivedate=June 10, 2016 }}</ref>{{Citation needed |reason=this source does not talk about enemas |date=June 2016}}
 
=== Classification===
Intussusception occurs more frequently in boys than in girls, with a ratio of approximately 3:1.<ref name="eMedicine.com">{{Cite web|url=http://www.emedicine.com/emerg/topic385.htm|title=Pediatrics: Intussusception|accessdate=2006-06-05|year=2006|author=Lonnie King|url-status=live|archiveurl=https://web.archive.org/web/20060518161052/http://www.emedicine.com/emerg/topic385.htm|archivedate=2006-05-18}}</ref>
 
In adults, intussusception represents the cause of approximately 1% of [[bowel obstruction]]s and is frequently associated with [[neoplasm]], [[cancer|malignant]] or otherwise.<ref name=gayer>{{cite journal | vauthors = Gayer G, Zissin R, Apter S, Papa M, Hertz M | title = Pictorial review: adult intussusception--a CT diagnosis | journal = Br J Radiol | volume = 75 | issue = 890 | pages = 185–90 | year = 2002 | doi = 10.1259/bjr.75.890.750185 | pmid = 11893645 | url = http://bjr.birjournals.org/cgi/content/full/75/890/185 | url-status = live | archiveurl = https://web.archive.org/web/20100509185634/http://bjr.birjournals.org/cgi/content/full/75/890/185 | archivedate = 2010-05-09 }}</ref>
 
== References ==
1,257,925

edits