Intussusception

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Sections available in full article Introduction, Presenting signs, Age predisposition, Special risks (e.g. anesthetic), Pathogenesis, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Ken Harkin DVM DipACVIM
Mr James Simpson SDA BVM&S MPhil MRCVS

Introduction

  • Invagination of a portion of gastrointestinal tract into a posterior or preceding segment of intestine.
  • Cause : thought to be due to vigorous contraction of a segment of intestine into the lumen of the adjacent relaxed segment, disruption of migrating motor complex, disturbed conduction patterns.
  • Signs : abdominal discomfort, abdominal mass, vomiting, diarrhea, anorexia, lethargy, dehydration.
  • Diagnosis : age, signs and radiography, ultrasound.
  • Treatment : surgery.
  • Prognosis : favorable if rapidly diagnosed and treated.

Diagnosis

Clinical signs

  • Abdominal pain.
  • Palpable abdominal mass.
  • Dehydration.
  • Gas distension of GI tract.

Diagnosis

Differential diagnosis

  • Other small intestinal obstruction Intestine: obstruction :
    • Small intestinal neoplasia Small intestine neoplasia.
    • Small intestinal foreign body Intestine: linear foreign bodies.
  • Rectal mass Large intestine: neoplasia.
  • Other causes of tenesmus.
  • Acute ileus Ileus.
  • Severe gastroenteritis of other cause.
  • Mesenteric torsion.
  • Atresia colon Anus: atresia (or other congenital abnormality) in neonate.

Sequelae

Prognosis

  • Regardless of the intra-operative findings and subsequent surgical manipulation, the most problematical aspect of therapy is to prevent recurrence.

Expected response to treatment

  • Cessation of vomiting (if present).
  • Appetite returns and normal motion passed.

Reasons for treatment failure

  • In dogs the recurrence rate has been reported to be approximately 20%, usually within 72 hours following surgery.
  • A multiple enteropexy procedure that apposes the serosal surface of the small intestine extending from the proximal jejunum to the ileocolic valve may be indicated.
  • Early oral alimentation may promote normal GI tract motility and reduce likelihood of recurrence.

Sources

Publications

Refereed papers

  • Applewhite A A, Cornell K K & Selcer B A (2001) Pylorogastric intussusception in the dog - a case study and literature review. JAAHA 37 , 238-243.
  • Borgarelli M, Biller D S, Gogin J M & Bussadori C (1998) Ultrasonographic examination of the gastrointestinal tract Part 2. Ultrasonographical identification of gastrointestinal disease. EJCAP 8 , 57-65.
  • Lamb C R & Mantis P (1998) Ultrasonographic features of intestinal intussusception in 10 dogs. JSAP 39 (9), 437.
  • Oakes M G, Lewis D D, Hosgood G & Beale B S (1994) Enteroplication for the prevention of intussusception recurrence in dogs - 31 cases (1978-1992). JAVMA 205 , 72-75.
  • Penninck D G, Nyland T G, Kerr L Y & Fisher P E (1990) Ultrasonographic evaluation of gastrointestinal disease in small animals. Vet Rad 31 , 134-141.
  • Lewis D D, Ellison G W & Oakes M G (1987) Intussusception in dogs and cats. Comp Cont Ed 9 , 523-532.

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