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Intussusception in dogs and cats

Description
What is intussusception?
Intussusception is the prolapse or falling down of one portion of the gastrointestinal tract into the lumen of an adjoining segment. Intussusception can occur in the esophagus, stomach, or intestines. It results in partial or complete gastrointestinal obstruction, leading to fluid loss and dehydration. German shepherd dogs and Siamese are more likely to develop intussusception. The majority (80%) of affected animals are less than one year of age.





llustration of an intussusception showing the invaginated intussusceptum (blue) and the invaginating intussuscipiens (red) . (A) demonstrates a direct or normograde intussusception occurring in the direction of normal peristalsis. (B) demonstrates an indirect or retrograde intussusception occurring against the normal direction of peristalsis.






Intussusception courtesy Dr. K.L. How

Additional information


Definition
A prolapse or invagination of one portion of the gastrointestinal tract into the lumen of an adjoining segment. The invaginated segment is the intussusceptum and the ensheathing segment is the intussuscipiens. Intussusceptions are classified according to location within the alimentary tract: enterocolic (ileocolic; most common location), cecocolic, enteroenteric, duodenogastric, gastroesophageal. High intussusceptions may be defined as those proximal to the jejunum whereas low intussusceptions are those distal to the duodenum.

Pathophysiology
Although the exact physical and mechanical events that lead to intussusception are unknown, uncoordinated peristalsis is probably involved. Vigorous contraction of a bowel segment causes invagination of that segment into an adjacent flaccid segment. Regions of the GI tract that undergo abrupt change in anatomic diameter (e.g., ileocolic or gastroesophageal junctions) seem to be at high risk. Ileocolic intussusception is associated with active enteritis (especially in young animals). Intussusception results in partial or complete GI obstruction leading to hypovolemia and dehydration.Vascular compromise is common, especially to the intussusceptum. Compromise can range from venous and lymphatic obstruction to arterial obstruction with full-thickness necrosis.There may be disruption of the mucosal barrier allowing absorption of bacteria and/or endotoxin and exacerbation of shock.

Systems Affected
  • Gastrointestinal





    An intra-operative view of an intussusception Notice that one section of the small intestine has telescoped into the adjoining section.
  • Cardiovascular Hypovolemic or septic shock
  • Multiple organ failure may ensue in severe untreated cases.

    Genetics
    Heritability is unproven although gastroesophageal intussusception (GEI) has been reported in multiple littermates.
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