As the name implies, intussusception is when one segment of the intestine is trapped in the other segment to which it is attached.
Primary intussusception is most common in children under 2 years of age and is mainly due to disturbances in the peristaltic rhythm of the intestine. Secondary intussusception is usually seen in adults and is caused by dysregulation of the peristaltic rhythm of the intestinal lumen or intestinal wall lesions, where the strong peristaltic movement of the proximal intestine and the lesions are simultaneously snapped into the distal intestine.
If the mesenteric vessels supplying the proximal intestine are snapped into the other end of the intestine, it may lead to intestinal necrosis and perforation, peritonitis and abdominal exudation.
The main clinical manifestations are: abdominal pain, bloody stools and abdominal masses. It is a sudden and severe paroxysmal abdominal pain, and children are crying and restless because they cannot describe their true feelings, or there are quiet periods without pain. It is accompanied by vomiting and/or jam-like bloody stools. In children, the pain is usually ileocaecal impaction, while in adults it may be ileocaecal impaction, small bowel impaction, colonic impaction, etc. In the early stage of the disease, a coarse strip-shaped mass with pressure pain, smooth and movable can be palpated on abdominal palpation. With the progress of the disease may appear symptoms of intestinal obstruction such as abdominal distension, or even intestinal perforation, intestinal necrosis, peritonitis and other manifestations, the patient will have severe pain, which will be painful to the heart. Some patients with fast progression of the disease process appear peritonitis performance, abdominal muscle tension may not be able to palpate the abdominal mass, not to mention the abdomen to talk about the feeling of emptiness.
At present, the clinical diagnosis is mostly inclined to combine abdominal ultrasound or abdominal CT on the basis of history taking and physical examination, and the diagnostic means is simple and crude, real and effective.
Treatment: For ileal intussusception, air enema can be used. If the intussusception cannot be reset, or if the condition worsens, consider intestinal necrosis, intestinal perforation, symptoms of peritoneal irritation and deterioration of general condition, surgery should be considered. For other types of intussusception, different therapeutic measures should be taken under close observation, and non-surgical treatment can be adopted if the intussusception is reset by itself. If the condition worsens, surgery can be used. If there is no intestinal necrosis, only intestinal repositioning can be performed; if there is ischemic necrosis of the intestinal wall, intestinal resection and anastomosis should be performed; if the general condition is poor, necrotic intestinal resection with external intestinal stoma in the near and distant segments is feasible, and second stage surgery.
Preliminary diagnosis of intussusception, must be treated under close observation of medical staff, listen to the doctor’s advice and treatment measures, so as not to lead to adverse consequences.