Intussusception (Twisted bowel)
this pathology represents the implementation process of the intestine in the lower part of the intestine, resulting in blockage and obstruction of the contents by the intestinal tract. Adult intestinal intussusception is rare. Most often in such cases, it provoked the development of a tumor or polyp in the intestines, the emergence of diverticulosis or fecal stone.
There are several forms of intussusception
- small bowel (when the process of intussusception occurs in the small intestine)
- thin-colonic (introduction small intestine to the large)
- iliac colon (ileum grows in the colon)
- bowel (volvulus in the region of the large intestine)
- blindly colon (intussusception of the cecum into the colon).
There are also extremely rare form
- the introduction of the Appendix in the cecum
- intussusception of Mekele (introduction into the colon of a diverticulum of the sacciform education mekkala the small intestine, which is a congenital phenomenon)
- multistage (volvulus in several places at the same time).
Causes of volvulus may be different. Often, the intussusception occurs in connection with digestive disorders, formation of tumor in the region of the intestinal tract or fecal stones. In addition, the disease can trigger poor nutrition, excessive consumption of solid food. Such include nuts, persimmons. Injuries to the abdomen can cause a volvulus. The reason for such injuries may serve as an accident, severe injury when falling from a height or just a punch in the stomach. The intussusception can also occur due to a variety of parasites living in the human body. These include pinworms, opistorhoz, roundworm and tapeworm. A large number of polyps can lead to volvulus. Tumors that obstruct the bowel lumen, do not give fecal masses take place normally and thus provoke an intussusception. Poisons that can injure the nervous mechanism of the intestine, of course, will cause the volvulus.
Most common intussusception of the intestine in children. The main symptom of volvulus is acute pain in the region of the intestinal tract, arising, despite the fact that, in General, a person is healthy. There is such pain every five to ten minutes with a duration of three to four minutes. Pain appear and disappear in connection with the wave reduction of the intestine, during which the intruded part of the intestine moves inside. After the beginning of the unpleasant somatic, after a couple of hours, there is a delay of feces (before the process of defecating everything was fine). Constant nausea accompanies the patient all this time, with increasing episodes of vomiting, which can bring relief. The presence of blood in the feces, with the consistency of jelly, indicates bleeding in the intestine. The temperature of the person may rise to thirty-nine degrees. By palpation it is possible to identify a cylindrical mass in his abdomen. After ten or twelve hours the patient swells the stomach, increase pain, vomiting becomes more frequent.
Diagnosis of intussusception includes a variety of procedures. The patient ask, happened to him like this before, and if so, how long. Were close relatives of such pathology.
Further, a thorough examination of the patient. Feel your belly, with the aim of identifying oblong formation in the intestines. Similarly, you can find an empty rectum, which means difficulty in the passing of feces. Examine feces. Blood or mucus in the stool signs of intussusception.
Then conduct laboratory studies of the patient. Do a blood test, which can reveal an inflammatory process and elevated white blood cell count. Conducted biochemical analysis of blood it gives the chance to determine a malfunction of the internal organs that caused by intoxication. Also do analyses of the excrement to prevent hemorrhage in the intestine, as well as to monitor the status of the urinary system.
After all these procedures, the instrumental method of diagnosis. Patient do ultrasound of the gastrointestinal tract, which are looking for oblong cylindrical formation, which fully confirms the diagnosis of volvulus. The person doing the x-ray of the abdominal cavity, which can use tools enema with barium or air, it gives the opportunity to make the more pronounced. With this procedure, the doctor tries to find signs of intestinal obstruction and identify the site of the volvulus. Can also apply for examination of computer tomography, which gives the ability to drill down assessment of the intestine and the damage.
Intussusception in children and adults is eliminated surgically.
When the diagnosis of intussusception, the treatment can occur in several ways
- laparotomy (for this kind of operation, cut the abdominal wall)
- disinvagination (manually straighten imaginitave part of the intestine)
- removal of a section of intestine, if there is necrosis
- laparoscopy (includes endoscopic evaluation and surgery performed on the organs of abdominal region and pelvis. The operation is done using video equipment and surgical instrument. Today, this kind of operation is more in demand, as less traumatic, and after they are not left many scars and a huge scar)
- treatment of pathologies which arose intussusception of the intestines, tumors, polyps, fecal stones.
Complications that can occur with volvulus
- obstruction of feces in the intestine
- poisoning of the body due to the absorption of toxins into the blood associated with a stagnation of the intestinal contents
- inflammation of the abdominal cavity
- the rupture of the intestine
- the reappearance of symptoms of intussusception.
After surgery and treatment of volvulus can occur relapse. If this happens, you have to remove the part of bowel that is prone to intussusception.
Prevention of volvulus includes a complete diet. Should give up the bad foods (fried and spicy food, smoked) for the benefit of healthy foods (cereals, vegetables and fruits). Harmful habits can also affect the occurrence of intussusception of the intestines. To timely detect and therefore to treat disorders that can lead to volvulus.