Intussusception

Presented by: GROUP 1

 DEFINITION
Intussusception is a serious condition that occurs when a portion of the intestine
invaginates or telescopes into an adjacent segment of the intestine, causing
obstruction, ischemia, and inflammation. Intussusception is defined as the
invagination of one segment of the bowel into an immediately adjacent segment of
the bowel. Idiopathic ileocolic intussusception is the most common form in
children and is typically managed with nonoperative reduction via pneumatic
and/or hydrostatic enemas. In the adult population, intussusception is uncommon
and occurs more often in the small intestine than in the colon. This condition is
most common in infants and young children, but it can also occur in adults.
intussuscipiens intussusceptum
 ETIOLOGY
The cause of intussusception is not well understood, but it is thought to
be related to a combination of factors, including viral infections,
lymphoid hyperplasia, and structural abnormalities of the intestine. The
most common trigger for intussusception is thought to be a viral
infection, particularly with the adenovirus or rotavirus. Other risk
factors for intussusception include age (most cases occur in children
under 2 years of age), male gender, and a history of previous
intussusception.
 ETIOLOGY
PREDISPOSING FACTORS PRECIPITATING FACTORS
Age Infections
Sex Altered motility
Anatomical factors Polyps
Apendicitis
 SYMPTOMATOLOGY
The classic triad of symptoms associated with
intussusception includes abdominal pain, vomiting, and
bloody stool (called currant jelly stool). However, this
triad is only present in about 20% of cases, and the
presentation can be variable. Other symptoms of
intussusception may include fever, lethargy, irritability,
and a palpable abdominal mass.
 INTUSSUSCEPTION PATHOPHYSIOLOGY
PREDISPOSING FACTORS: PRECIPITATING FACTORS:
Age A peristaltic action of the intestine pulls the proximal segment into the distal segment.
Infections
Sex Altered motiliy
Anatomical factors Ileum enters the cecum Polyps
Apendicitis
The trapped section of the bowel may have its blood supply cut off

ISCHEMIA

The mucosa responds by causing sloughing off into the gut

“Red currant jelly” composed of mucosa, blood, and mucus

Abdominal pain Fever
Vomiting INTUSSUSCEPTION Lethargy,
Bloody Stool Irritability
DIAGNOSTIC TESTS: Palpable abdominal
Ultrasound, Air Enema, Abdominal X-ray mass.

MEDICAL MANAGEMENT
Non-surgical: barium, water-soluble, or air-contrast enema
Surgical: Laparoscopy
Pharmacologic: Analgesics, Antibiotics, Dexamethasone

IF TREATED: IF NOT TREATED:

most children with intussusception recover it can lead to complications such as bowel ischemia, perforation,
without long-term sequelae. and peritonitis, which can increase morbidity and mortality.
 MEDICAL MANAGEMENT
NON-SURGICAL MANAGEMENT:
Barium, water-soluble, or an air-contrast enema

SURGICAL MANAGEMENT:
Laparoscopy

PHARMACOLOGIC MANAGEMENT:
Analgesics (ibuprofen, acetaminophen) - reduce pain
Antibiotics - treat infection
Dexamethasone - may be effective in reducing
intussusception recurrence rates following air enema
or liquid enema
DIAGNOSTIC TEST
Ultrasound - Screening test for children
with non-classical clinical features.
Air enema - Air is pumped in through a
tube in the rectum. Both a diagnostic
procedure and a treatment
Abdominal Xray - Reserved for children with
clinical evidence of peritonitis and possible
perforation, an atypical clinical presentation
 NURSING DIAGNOSIS
Some common nursing diagnoses for intussusception include:
• Acute pain related to abdominal distension, ischemia, and inflammation
• Risk for fluid volume deficit related to vomiting and diarrhea
• Risk for infection related to invasive procedures and weakened immune system
• Anxiety related to the child's condition and potential surgery
 NURSING
MANAGEMENT
Nursing management of intussusception involves monitoring and assessing the
child's condition, providing supportive care, and educating the family about the
child's condition and care. This may include:

• Monitoring vital signs, intake and output, and laboratory values

• Administering medications as ordered, such as pain medications and antibiotics
• Providing intravenous fluids and electrolytes as needed
• Assisting with diagnostic tests and procedures, such as ultrasounds or enemas
• Educating the family about signs and symptoms of complications and when to
seek medical attention
 PROGNOSIS
IF TREATED… IF NOT TREATED…
most children with it can lead to complications such as
intussusception recover bowel ischemia, perforation, and
without long-term sequelae. peritonitis, which can increase
morbidity and mortality.
THATS ALL
THANK YOU!
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