Intussusception is a disorder of gastrointestinal tract. In this condition the proximal part of the intestine invaginates or slides into the adjacent distal portion of intestine. Imagine how a telescope slides. The overlapping of intestine leads to obstruction of the bowel as well as subsequent inflammation and bleeding. Intestinal intussusception in adults is not as common as in children. It accounts for an estimate of 5 percent of all cases of intussusceptions.
The main symptom of intussusceptions in adults is pain in abdomen, vomiting, and blood in stool. In adults intussusception occurs due to an underlying secondary cause unlike pediatric intussusceptions where the cause is not known.Certain pathological conditions of bowel such as Meckel’s diverticulum, intestinal polyps, malignant growth or adhesions after an abdominal surgery can become triggers for intussusception.
Majority cases of intussusception in adults need surgical repair to correct bowel obstruction. Untreated cases can lead to gangrene of intestine, perforation, infection and death of a person.
Common Causes Of Intussusception In Adults
Intussusception in adults can occur at any age but it is rare as compared to infants and children. Adults account for only 5 percent of all cases of intussusceptions put together. Of that only 1 percent can lead to obstruction.This condition can develop in males as well as females, but its occurrence is more in adult males as compared to females.
A person who has previous history of intussusception is at a higher risk of suffering from the recurrence. In adults intussusception occurs due to some prevailing underlying pathological condition. With conditions mentioned below a person is more susceptible to suffer from intussusception.
- Meckel’s diverticulum
- Diverticulum of colon
- Adhesion or scar tissue that remains after an intestinal surgery.
- Benign and cancerous growths in the abdomen.
- Anorexia nervosa and malabsorption are other two predisposing conditions that may cause small bowel intussusception.
- Majority of large bowel intussusception is caused due to malignant growth.
The most common locations of intussusception in intestine occur at the junction of freely moving segment and segment that remains fixed due to adhesion. The process of intussusception is initiated by the alteration in the normal peristaltic movement.
The esophagus, stomach and duodenum are rarely affected with intussusception because these organs are relatively less mobile as compared to small and large intestine.
Signs And Symptoms Of Intussusception In Adults
Here are some important signs and symptoms of intussusception present in adults:
- Spasmodic cramps in abdomen which may become worse over a period of time if not treated.
- Mild grade fever
- Feces laced with blood and mucus. Bleeding through rectum is more common if intussusception is of large bowel.
- Diarrhea or constipation
- Distension of abdomen
- A mass can be palpable while examining the abdomen.
- Patient often has sensation of incomplete evacuation if it is an intussusception of rectum and anus region.
- In rare cases a mass may be protruding from the anus.
Diagnosis And Treatment For Intussusception
Diagnosis of intussusception is possible with the help of clinical examination, medical history and radiological tests such as barium X-ray, ultrasound and CT scan of abdomen. The treatment of intussusception in adults is invariably surgery. Emergency surgical repair is necessary in almost 50 to 60 percent of all cases of intussusception in adults.
Whether the operation is to be performed with laproscope or an open approach is needed depends on the health condition of the patient, the location of intussusception and underlying pathology. A part of intestine is resected and the healthy parts are again anastomosed.
In small percentage of cases conservative approach of treatment is possible. If intussusception is associated with Crohn’s disease or caused due to malabsorption syndrome patient can be treated conservatively if the symptoms are not severe.