Rectorectal intussusception
Rectorectal intussusception
What is intussusception?
As sections of the intestine fold over each other, food and fluid have a harder time passing through as necessary, and blockages may form. The condition can also reduce blood supply to the affected area, leading to:
- a tear in the intestine wall
- infection
- the possibility of tissue death
Intussusception symptoms
Intussusception does not always produce symptoms immediately. When symptoms do begin, they may start suddenly. This is true for both children and adults.
Pain and bowel obstructions are the most common symptomsTrusted Source of intussusception. However, many other symptoms may be present, too.
Symptoms in children
Because intussusception is most common in children who cannot describe their symptoms, it can be challenging to recognize.
Intussusception typically causes fluctuating, or colicky, abdominal pain. Other symptoms such as nausea and vomiting may accompany this pain.
Between these sharp bouts of pain, symptoms may appear to resolve, and children may return to daily activities.
If intussusception results in decreased blood flow in the affected area, this pain may become constant.
Other symptoms may includeTrusted Source:
- a mass in the abdominal area that you can see or feel
- bloody stool
- nausea and vomiting
- diarrhea
- fever
- little or no energy
Symptoms in adults
Intussusception is rare in adults and can be difficult to diagnose for this reason. In addition, adults with intussusception will typically have nonspecific symptomsTrusted Source.
When symptoms of adult intussusception are present, they may include abdominal pain as well as nausea and vomiting. These symptoms are typically acute and may come and go.
This can lead some people to go weeks before seeking medical attention.
Complications
If intussusception isn’t treated quickly, it can lead to potentially life threatening situations, such asTrusted Source:
- dehydration
- intestinal obstruction
- a tear, or hole, in the wall of the intestine
- an infection in the lining of the abdominal cavity (peritonitis)
- shock
- sepsis
Diagnosis
Diagnosing intussusception usually starts with a review of symptoms and a physical examination.
A doctor may gently press on the abdomen to feel for a lump or other factor, such as tenderness, that could help determine the cause of your child’s symptoms. Doctors will typically then use imaging tests to confirm a diagnosis.
When a doctor suspects intussusception in children, an ultrasound imaging test is the method of choice for diagnosis.
This imaging test uses sound waves and a computer to generate images inside your body. An ultrasound does not expose you to any radiation and can accurately confirm, or rule out, intussusception in almost 100 percent of cases.
Other imaging methods, such as X-rays and CT scans, may also detect intussusception during tests for other causes of abdominal pain.
As cases of intussusception are less common in adults, doctors are more likely to detect the condition when scanning for other abdominal conditions or obstructions.
In some cases, doctors may use a lower gastrointestinal series, or barium enema, to diagnose intussusception. In this test, liquid barium or another fluid is inserted into your rectum to get a detailed X-ray image of the lower part of the small intestine.
If you have a mild case of intussusception, the pressure of the barium insertion can sometimes cause the folded tissue to return to its typical position.
How is intussusception treated?
The severity of intussusception is one of the key factors in determining its treatment. Your child’s age and general health are also important. Doctors will typically consider nonsurgical treatment methods first.
Nonsurgical methods
A barium saline or pneumatic pressure enema may be sufficient for treating intussusception. This procedure starts with the injection of air into the intestine. The pressure from the air may push the affected tissue back into its original position.
The fluid administered through the tube in your rectum may also help return the tissue to its proper place.
As explained in a 2017 journal article, nonsurgical methods have an approximate 85 to 90 percentTrusted Source success rate in children.
Surgical methods
If an enema is ineffective or there are signs of bowel necrosis (death of the tissue), surgery may be necessaryTrusted Source.
During the surgery
You or your child will be under general anesthesia during surgery, as the operation requires an incision in the abdomen.
Surgeons may carry out the surgery via a keyhole incision and by using small cameras (laparoscopy), or through a larger incision.
The surgeon may be able to restore your intestine to its original position manually. If there is any severe tissue damage, they may need to remove part of the intestine. They will then sew the remaining sections back together.