Intussusception in Adults

Intussusception in Adults

Articleintussusceptioninadults
Digestive Health
Men's Health
+2
Contributed byKrish Tangella MD, MBAOct 16, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Bowel Obstruction in Adults (due to Intussusception)
  • Intestinal Obstruction in Adults (due to Intussusception)

What is Intussusception in Adults? (Definition/Background Information)

  • Intussusception is a condition when a part of the intestine slides into an adjacent part of the intestine, like a telescope. The bowel is blocked or obstructed because the intestine overlaps itself
  • A blockage in the bowels leads to swelling, bleeding, and the inability of food to pass through the intestine. The most common symptoms of Intussusception in Adults are abdominal pain, vomiting, and traces of blood in feces
  • While there is no specific cause, previous secondary conditions are likely to be involved in the formation of a bowel obstruction. Intussusception is far more common in children, which account for 95% of all cases
  • Most of the time a bowel obstruction is treated with a surgical procedure involving replacement or reduction of the intestines. If left untreated, Intussusception in Adults can lead to infection, shock, and possibly death

Who gets Intussusception in Adults? (Age and Sex Distribution)

  • Intussusception in Adults can occur at any age, but this condition is much more common in infants and young children
  • Cases of Intussusception in Adults are fairly rare; only 5% of intussusception cases are in adults
  • Only about 1% of bowel obstructions are due to Intussusception in Adults
  • Both males and females are affected, but males are more likely to be affected than females
  • All racial and ethnic groups are at risk

What are the Risk Factors for Intussusception in Adults? (Predisposing Factors)

There are a few risk factors for Intussusception in Adults and these include:

  • Individuals who have had a previous episode of intussusception are at a higher risk of another one
  • If Intussusception is in a family’s medical history, the family members are at a higher risk of developing a bowel obstruction

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Intussusception in Adults? (Etiology)

There is no specific cause of Intussusception in Adults in some cases. However, 90% of the adult cases arise from pre-existing secondary conditions that lead to intussusception. These may include:

  • Polyps (clump of cells on colon)
  • Carcinoma (epithelial tissue cancer)
  • Colonic diverticulum (bulging pouches in intestines)
  • Meckel’s diverticulum (abnormal pouch on intestinal wall at birth)
  • Stricture (narrowing of body passage)
  • Neoplasms (abnormal tissue growth)
  • Adhesions in the intestine (scar tissue)
  • Weight-loss surgery
  • Inflammatory bowel diseases, such as Crohn’s disease

These conditions lead to the looping of the bowel in which blood flow is interrupted and cells begin to die.

What are the Signs and Symptoms of Intussusception in Adults?

Common signs and symptoms of Intussusception in Adults may include:

  • Abdominal pain that comes and goes; abdominal cramping
  • Nausea, vomiting
  • Weight loss
  • Fever
  • Constipation; melena (dark feces containing traces of blood)
  • Diarrhea
  • Abdominal distension

Some individuals do not present any signs and symptoms of the condition.

How is Intussusception in Adults Diagnosed?

Intussusception in Adults is generally diagnosed in the following manner:

  • First, a healthcare provider examines the individual to make sure their symptoms, medical history, and physical examination are suggestive of intussusception
  • Signs of intussusception that can lead to a diagnosis include abdominal distension, a palpable mass in the abdomen, and decreased abdominal sounds during an abdominal auscultation
  • Plain abdominal film X-rays may be used first to find a site of intestinal obstruction
  • An upper gastrointestinal contrast solution might be used to detect a “coil-spring” appearance of the intestines
  • An abdominal ultrasound can also be performed to help diagnose intussusception
  • An abdominal CT scan is used if other exams do not show signs of intussusception, because it has a higher rate of accurate diagnosis due to the fact that it can recognize intussusception without any pre-existing illness
  • An endoscopy may be performed of the lower gastrointestinal tract to find the cause of the bowel obstruction and look for any inversions of the intestines

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Intussusception in Adults?

The following complications may occur due to Intussusception in Adults:

  • The bowel obstruction can lead to a lack of blood supply to the intestine and the intestinal tissue can die
  • Intestinal tissue death can lead to tears in the wall of the intestines and infections can spread into the abdominal cavity
  • Peritonitis (inflammation of the peritoneum) can result and cause shock and unconsciousness

How is Intussusception in Adults Treated?

The most common form of treatment for Intussusception in Adults is surgery.

  • Often, adults with intussusception have large structural issues in the intestines and surgery is necessary. Unlike intussusception in small children, air and barium enemas are not frequently used as treatment options in adults
  • The point of bowel obstruction in the intestines is removed and either replaced or reduced with a surgical procedure

How can Intussusception in Adults be Prevented?

  • Intussusception is difficult to prevent, since it can be caused by a pre-existing condition
  • If other secondary or underlying conditions are already present, then proper care and treatment (if necessary) must be taken, so that the illness does not lead to a complete bowel obstruction

What is the Prognosis of Intussusception in Adults? (Outcomes/Resolutions)

  • If treated early on and quickly, Intussusception in Adults can be completely cured. The prognosis in such cases is good
  • Once an individual has a blockage, there is always a risk that it might recur
  • A quick diagnosis and surgical treatment are the most important factors in dealing with intussusception

Additional and Relevant Useful Information for Intussusception in Adults:

Intussusception only accounts for 1-5% of individuals with an intestinal blockage, but the cases can be very severe. If any symptoms are suspected, an individual should contact a healthcare provider immediately.

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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