How to diagnose Intussusception? - Dr. Nagaraj B. Puttaswamy

Intussusception is a surgical emergency. The patient presents all of a sudden pain abdomen, vomiting, distension of the abdomen. Why does this happen. There is an acute blockage of the intestine or allowing the food particle or liquid content whatever is there inside the small intestine or the large intestine to go beyond this block. How does this block occur? Because the proximal intestinal wall is trying to go throughout the distal part of the adjacent intestine due to some reasons it can be diagnosed as an acute intestinal infection only at a clinical level. We will not be able to diagnose it clinically that this patient has got acute intestinal intussusception. But if it is baby or a thin patient, we will feel like a mass in the abdominal wall in the abdominal cavity when we examine the patient and you should be able to pick up that there is a mass. Mass could be anything other than intussusception also. A cancerous condition can cause acute intestinal obstruction and it can be felt like a mass in the abdomen. But we can clinically diagnose acute intestinal obstruction and not commit as intussusception. But there are other evidences like x-ray of the abdomen that will say there is a possibility of intestinal obstruction and in an ultrasound if a radiologist is smart, he can pick up an intussusception happening or he can go for a CT scan which 99% of the time be in a position to identify that there is an intussusception that has happened are whatever levels, whether jejunojejunal, jejunoileal, ilieoilial, ileocolic or colocolic. So depending upon the location, they can easily identify and tell the level at which the intussusception is happening. So we have to manage the patient. Hospitalize the patient, put the patient on IV line, keep the patient on empty stomach , decompress the GI system and probably come with diagnostic laparoscopy and laparoscopy will be the perfect diagnosis to identify the location and also to do a therapeutic management in the form of corrective surgical procedure.