Intussusception Case Study

ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.

The authors of, Journal of Trauma Management & Outcomes: Free abdominal fluid without obvious solid organ injury upon CT imaging: an actual problem or simply over-diagnosing, Vanessa M. Banza, Muhammad U Butt, Heinz Zimmermann, Victor Jeger and Aristomenis K Exadaktylos partnered together to provide the reader with current literature and available information in an overview of diagnostic and therapeutic approaches for over-diagnosing free abdominal fluid without evidence of organ

Patient might experience mild or sever pain, crampy, and aching that is similar to appendicitis. Passing of gas or stool elimination may reduce the adverse effect of pain. According to spivak & deSouza (2008), patient that are of high risk are those with the history of low-fiber diet, constipation, high intake of red meat, severe dehydration, and aging. The diagnostic tests are barium enema which determines number of diverticula, CBC indicates present of anemia, colonoscopy exposes present of diverticula, CT scan reveals changes in the colon wall, GI bleeding scan that identifies active bleeding, and CBC with differential reveals leukocytosis.

Unlike many other medical problems, we still don't know the cause of intussusception. It is believed to be caused by a viral infection, but no definite findings are present. There are other theories that state this illness is caused by a polyp in the intestinal tract or a previous surgery. Intussusception is usually found in children between the ages of three months old and six years of age. Although, sixty percent of the children who develop this illness are between the ages of two months and one year. Developing this illness can be extremely painful and the symptoms can be mistaken for something else.

The upper GI series shows a dilated first and second portion of the duodenum with an abrupt and vertical obstruction of the third portion. (Gebhart 2015). CT scan may also be used to provide images of both the abdominal tissue in cross-sections allowing to see the superior mesenteric artery and the abdominal aorta including the internal organs (Brunner's and Suddarths 2014). An Endoscopic ultrasound can also be used to visualize the aorta mesenteric angle with accuracy. The use of an upper endoscopy can rule out other pathologies such as mechanical lumen structure and duodenal ulcerations that can mimic superior mesenteric artery syndrome (Gebhart

Irritable bowel syndrome is described as a chronic illness that affects about one out of every five Americans. It is characterized as an ailment of the large intestine that causes cramping, abdominal pain, bloating, gas, and diarrhea, or constipation; sometimes both. There are different types of IBS, however, both affect the abdominal area. However, only a small number of people have extremely severe symptoms. Many people are able to manage/ control their symptoms through changes in diet, stress, and lifestyle. In more extreme cases, medication as well as counseling is used. .

Ileus is a condition in which the intestines, also called the bowels, stop working correctly. If the intestines stop working, food cannot pass through. The intestines are hollow organs that digest food after the food leaves the stomach. These organs are long, muscular tubes that connect the stomach to the rectum. When ileus occurs, the muscular contractions that cause food to move through the intestines stop happening as they normally would.

Intususepsi or invaginasi is the process by which a segment of the proximal bowel gets into the lumen of the bowel causing obstruction bowel distalnya and can end up with strangulasi 1-4 General part the proximal (intususeptum) goes into the distal part (intussussipien). 6 this disorder is one of the kegawatdaruratan so it should be identified quickly and precisely and require handling soon due to misdiagnosis or delay in diagnosis will increase the number morbiditas1-6.

Intussusception is the folding of a segment of the intestine into another further downstream and is the most common cause of intestinal obstruction in children 3 months to 6 years. Intussusception occurs primarily in infants (most often male and female), but can also occur in adults.

Small bowel obstruction (SBO) is a blockage that keeps food or liquid from passing through the small intestine or large intestine. It can be partial or complete. This disorder is very irritable and causes many discomforts like abdominal cramping, fever, “Abdominal pain, abdominal distention, nausea, and vomiting are the usual signs and symptoms of SBO” (Barzegari, et al. 2016, p. 201). According to Buttaro et al. (2013), the three differential diagnoses that can be included with this disorder are ischemic colitis, paralytic ileus, and gastroenteritis. Bowel obstruction occurs when the normal flow of intraluminal contents is interrupted. According to Bordeianou, et al. (2016), the pathology that causes the obstruction may be external to the

The gastrointestinal tract in the most common location that intussusception occurs. Generally, any areas that include freely moving segments or segments that are tightly adhered to one another, are the most affected. Intussusception has been classified as either being benign, malignant, or idiopathic, with malignancy accounting for up to 30% of cases in the small intestine. The medical appearance of adult intussusception varies considerably. The classic pediatric presentation of acute intussusception-- a combination of cramping abdominal pain, bloody diarrhea and a palpable tender mass--is rare in adults. Nausea, vomiting, gastrointestinal bleeding, change in bowel habits, constipation or abdominal distension are the nonspecific symptoms and

Benign Diseases of the Anorectum. In: Maingot’s Abdominal Operations. Zinner MJ, Schwatz SI, Ellis H (Eds), 10th Edition, Prentice Hall International. London, 1997; pp.

Initial use of ultrasonography in diagnosis of intra-abdominal collections was found to have several advantages and disadvantages. The accuracy of ultrasonography in diagnosis of intra-abdominal collection was found to be 97% with sensitivity of 93% and a specificity of 99% 14.

Nonmechanical obstructions most frequently occur because of surgery, trauma, infection or mesenteric ischemia (book…761). There are certain medicines that are commonly prescribed after surgery that can decrease peristalsis in the intestines. Hydromorphone, morphine, oxycodone, and tricyclic antidepressants can contribute to paralytic ileus (healthline). Some gastrointestinal disorders are also known to contribute to ileus, such as; intestinal cancer, Crohn’s disease, diverticulitis, Parkinson’s disease and in children, the most common cause is intussusception. (healthline).

Volvulus is rotation of part of the intestine around its mesentry, causing a intestinal obstruction. Colonic volvulus is not common cause of intestinal obstruction in the developed world. However much more common in the developing world (6,7). High prevalence of volvulus are reported in the “Volvulus Belt” of Africa, the Middle East, India, and Russia. In these regions, the average age is younger than Western countries, ranging from 40 to 50 years and in generally better health (8). In the United States, colonic volvulus accounts for 10 to 15% of all colon obstructions(9).