Precipitating factor:

Predisposing factors:

y y y Age Gender y

Abnormal intestinal formation at birth Prior history of intussusception

Etiology: UNKNOWN

s/sx:
imbalance in the forces of the intestinal wall

-Colicky pain -n/v -bowel distention -malaise - currant jelly stool -tender, sausageshaped abdominal mass

Increased intraluminal Pressure Prolonged increase pressure

Mesentery, vessels, and nerves are being dragged area of the intestine invaginates into the lumen of adjacent bowel (intussusceptum) completely telescopes into the receiving portion of the intestine (intussuscipiens)

Dx test: x-ray, barium enema, USD, ct scan Mgt: Surgical reduction, Hydrostatic reduction, ileostomy Obstruction

intussusceptum proceed to the distal colon or sigmoid

Prolapse into the anus

Retention of particulate material

Compression of the veins and lymphatic vessels

Fluids are not absorbed into bloodstream

Peristalsis temporarily increases in attempt to force contents past obstruction

Impeded lymphatic return and venous drainage

dehydration

Distention increases at and above obstruction site

fever

Inflammation of the region

B A
arterial inflow is inhibited

Decrease Blood flow

Severe Bleeding
ischemia

erosion of the mucosal lining

Transmural gangrene

Perforation

Sepsis

hypervolemia

If treated:

If not treated:

CONVALESCENCE

DEATH

NARRATIVE PATHOPHYSIOLOGY
There are several predisposing and precipitating factors that lead to the development of illness. In the case the of intussusception, the precipitating factors are abnormal intestinal formation at birth and a prior history of intussusception. It has been observed that the prevalence of intussusception is common in infants. On the other hand, the predisposing factors are age and gender. Intussusception occurs 70% in infants before 2 years of age and is two to three times more common to males than in females. Intussusception is the telescoping or invagination of one portion of the intestine into another. Usually, the ileum invaginates the cecum and part of the ascending colon by collapsing through the ileocecal valve. Area of the intestine invaginates into the lumen of adjacent bowel (intussusceptum) and completely telescopes into the receiving portion of the intestine (intussuscipiens) these signs and symptoms may be present: Colicky pain, nausea and vomiting, bowel distention, malaise, currant jelly stool and tender, sausage-shaped abdominal mass.

Invagination can be diagnosed by performing x-ray, ultrasound, ct scan and barium enema. And can be managed by performing a surgical reduction or hydrostatic reduction and a temporary ileostomy. If intussusceptum proceeds to the distal colon or sigmoid and prolapsed into the anus, severe bleeding may occur and can cause hypervolemia. Obstruction may also occur if there is intussusceptions and if there is obstruction, there would be retention of particulate materials. As the body tries to compensate, peristalsis temporarily increases in attempt to force contents past obstruction. Distention also increases at and above the site. Obstruction may also a cause of compression of the veins and lymphatic vessels and lead to

Impeded lymphatic return and venous drainage. These would cause an inflammation of the region. If there is inflammation, arterial inflow is inhibited leading to ischemia and erosion of mucosal lining occurs and furthered to transmural gangrene, then eventually perforation and then to sepsis. Obstruction prevents the absorption of fluids into the bloodstream that causes dehydration and dehydration causes decreased in blood flow and then cause hypervolemia. If the condition is treated, there would be convalescence. But if treatment is not given, this condition would lead to death.

A. Etiology and Symptomatology Predisposing Factors  Age Nearly 75% of intussusceptions occur before age 2 years; 70% occur before age 1 year. Intussusception is rare in infants younger than 3 months and is in frequent after 36 months. Our patient is only 6 month-old, which shows that she belongs to the 70% rate of having this condition.  Gender Intussusception involving the ileum and the colon accounts for 80% to 90% of intestinal Presence Justification

obstructions in infants and is two to three times more common in males than in females.

Precipitating Factors

Presence

Justification

Malrotation, Abnormal intestinal formation at birth (congenital)

a in

condition which the

present intestine

at

birth

doesn't

develop correctly, also is a risk factor for intussusception. Once you've had intussusception, you're at

Prior history of intussuscepti on

increased risk to develop it again.

Symptom

Presence

Justification Fever is the body's natural way of defending

Fever 

itself from invaders like viruses and bacteria because many of them can't survive in the body due to the high temperature caused by a fever. High body temperatures also signal infection-fighting cells of the immune system such as phagocytes, neutrophils, and

lymphocytes to defend and help fight off infections. The degree of temperature

increase doesn't necessarily correspond to the severity of the illness. The primary symptom of intussusception is Colicky pain  described as intermittent crampy abdominal pain. This is often called "colicky pain." Intussusception in an infant usually starts with the infant suddenly crying very loudly, as if in great pain. The infant intermittently draws the knees up to the chest while crying. This reaction is caused by the abdominal pain which recurs frequently and increases in intensity and duration. These intermittent painful episodes are believed to be caused by the telescoping of the bowel and resultant compression of blood vessels and nerves.  Nausea and Vomiting  Bowel distention Obstruction in the colon may cause

regurgitation of stomach contents. Obstruction prevents normal transit of the products of digestion to pass through into the colon.

Malaise

Impaired digestion process may be attributed with deficient nutrition and weakness

currant jelly stool tender, sausage-shaped abdominal mass

 

Due to blood and mucus content. Due to the telescoping of one portion of the intestine into another