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Intussusception (medical disorder)

Intussusception
VolvulusCT.PNG
An intussuception as seen on CT
Classification and external resources
Specialty Pediatrics, general surgery
ICD-10 K38.8, K56.1
ICD-9-CM 543.9, 560.0
OMIM 147710
DiseasesDB 6913
MedlinePlus 000958
eMedicine emerg/385
MeSH D007443
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An intussusception is a medical condition in which a part of the intestine invaginates (folds into) into another section of intestine, similar to the way the parts of a collapsible telescope retract into one another. This can often result in an obstruction. The part that prolapses into the other is called the intussusceptum, and the part that receives it is called the intussuscipiens. Intussusception is a medical emergency and a patient should be seen immediately to reduce risk.

Early symptoms can include periodic abdominal pain, nausea, vomiting (sometimes green in color from bile), pulling legs to the chest area, and intermittent moderate to severe cramping abdominal pain. Pain is intermittent—not because the intussusception temporarily resolves, but because the intussuscepted bowel segment transiently stops contracting. Later signs include rectal bleeding, often with "red currant jelly" stool (stool mixed with blood and mucus), and lethargy. Physical examination may reveal a "sausage-shaped" mass, felt upon palpating the abdomen. Children, or those unable to communicate symptoms verbally, may cry, draw their knees up to their chest, or experience dyspnea (difficult or painful breathing) with paroxysms of pain.

Fever is not a symptom of intussusception. However, intussusception can cause a loop of bowel to become necrotic, secondary to ischemia due to compression to arterial blood supply. This leads to perforation and sepsis, which causes fever.

In rare cases, intussusception may be a complication of Henoch-Schönlein purpura (HSP), an immune-mediated vasculitis disease in children. Such patients who develop intussusception often present with severe abdominal pain in addition to the classic signs and symptoms of HSP.


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