Mod 5-3 LB Intussusception Flashcards
The condition of large bowel intussusception is primarily seen in what age group?
Children
What is intussusception?
The telescoping of one part of the bowel into another.
What is intussusception often caused by in children?
Peristaltic activity with no other underlying cause
What is intussusception often caused by in adults?
Usually an abnormality at the site of intussusception
- polyp
- cancer
- diverticulum
Regardless of the cause, what will peristaltic activity do when intussusception is present?
Peristaltic activity will drag the leading edge further into the sheathing portion; at some point involving the bowel’s vascular supply if prompt attention is not given to reverse and resolve the process.
Where does intussusception most commonly appear in children?
Most commonly appears in the ileocecal valve area, but may occur anywehre along the small or large bowel.
Peristaltic activity is strong in the _______ _____ area as the small bowel attempts to push material into the large bowel.
ileocecal valve
What are the clinical signs of intussusception in children?
- Sudden acute, severe abdominal pain
- Abdominal mass felt in right side (cecal region)
- “Currant jelly” stool (blood and mucus)
What are the clinical signs of intussusception in adults?
Simliar to children, though most commonly they tend to have subacute or chronic symptoms such as collicky pain, nausea and vomiting.
What will be the first radiographic exam to be ordered when a patient has a clinical history of intussusception?
Acute abdominal series
What can occasionally be seen on a radiograph with intussusception?
“coiled spring”
What is done once it has been established that intussusception in the large bowel is the most logical diagnosis?
A low pressure enema in the radiology department to confirm the diagnosis and attempt to relieve the obstruction.
*This is the only instance when a contrast enema is used for therapeutic procedure.
How much fluorscopic imaging will be used during therapeutic enema for an intussusception?
It will be limited to only demonstrate the presence of the intussusception and to document its successful reduction since this is therapeutic and not diagnostic.
What must be done if an enema is unsuccessful in correcting the intussusception?
Surgery will be required to relieve the obstruction.
What happens if there is a delay of 48 hours in treating intussusception?
A dramatic rise in a 1% mortality rate because this process may perforate the bowel or cause gangrene if not treated promptly.
