invaginaatiota

Invaginaatio is a medical condition where a segment of the intestine telescopes into an adjacent segment, much like the parts of a collapsible telescope. This telescoping action can obstruct the flow of food and waste through the digestive tract. It can also compress blood vessels, potentially leading to a lack of blood supply (ischemia) to the affected part of the intestine.

The most common form in infants and young children is ileocolic invagination, where the ileum (the final section of the small intestine) invaginates into the colon. In older children and adults, invagination is less common and may be associated with an underlying abnormality such as a polyp or tumor that acts as a lead point.

Symptoms can vary but often include sudden onset of severe, colicky abdominal pain that comes and goes, vomiting, and sometimes bloody stools that may have a characteristic "currant jelly" appearance due to mucus and blood. In infants, a palpable sausage-shaped mass may be felt in the abdomen.

Diagnosis is typically made using ultrasound, which can visualize the characteristic "target sign" or "doughnut sign" of the invaginated bowel. Barium enema or air contrast enema can also be used for diagnosis and sometimes for treatment.

Treatment depends on the duration of symptoms and the presence of complications. In uncomplicated cases, particularly in children, reduction of the invagination may be attempted non-surgically using air or contrast enema under radiologic guidance. If non-surgical reduction is unsuccessful, or if there are signs of perforation, peritonitis, or bowel obstruction, surgical intervention is required to manually separate the telescoped segments and remove any compromised bowel.