Intussusception
Topic Overview
What is intussusception?
Intussusception means that one part of the intestine has folded into itself, like a telescope. This can happen anywhere along the intestinal tract. It usually happens between the lower part of the small intestine and the beginning of the large intestine.
The part of the intestine that folds inward may lose some or all of its blood supply. This section of the intestine becomes swollen and painful. Intussusception needs to be treated right away. If not treated, it can cause life-threatening problems, such as an infection (peritonitis) or a hole or opening (perforation) in the intestine.
The problem usually happens in young children.
What causes intussusception?
The cause of intussusception in children isn’t known in most cases. Sometimes it happens after a child has a cold or has inflammation in the stomach and intestines.
What are the symptoms?
Symptoms usually begin suddenly. Your child may:
- Act fussy.
- Vomit often.
- Have severe belly pain and cramping that last from 1 to 5 minutes. Afterward, your child may seem normal, but another period of pain may start 5 to 30 minutes later.
- Have diarrhea or stools that contain blood or mucus.
- Have a swollen, painful belly. Your child may have a lump in the upper right side of the belly.
Your child may be getting worse if he or she has breathing problems or a fever or is dehydrated.
If your child has symptoms of intussusception, call your doctor right away.
How is intussusception diagnosed?
The doctor will ask about your child’s health history and symptoms and will do an exam. Intussusception can be hard to diagnose, because symptoms may come and go.
Your child may need an X-ray, an ultrasound, an enema, or other tests to confirm whether he or she has intussusception.
How is it treated?
Intussusception needs to be treated in the hospital. Treatment works best if it begins within 24 hours after the start of symptoms. Most of the time, intussusception is treated with an enema. In some cases, surgery may be needed.
- Enema. During an enema, air, saline, or barium (a milky-white liquid) is flushed through a child’s rectum into the intestines. The enema increases the pressure in the child’s intestine. This can cause the affected area to return to its normal position. It helps about 75 out of 100 children with intussusception.footnote 1
- Surgery. This may be needed if enemas haven’t fixed the problem after two or three tries, or if the intestine has been damaged. A cut (incision) is made through the skin into the belly, and the intestine is stretched out and returned to its normal position. Any damaged part of the intestine is removed.
If a large part of the intestine is removed during surgery, your child may need an ileostomy for a short time. This is an opening in which waste leaves the intestine and collects in an odor-proof plastic pouch fastened to the skin.
Talk with your doctor about how to care for your child at home. If your child had an enema to treat intussusception, watch for signs that the problem has come back. The symptoms are likely to be the same as the first time.
After surgery, watch for problems such as stomach upset, diarrhea, and fever. Take care of your child’s incision. It may need to be cleaned or checked for infection.
References
Citations
- Kaiser AD, et al. (2007). Current success in the treatment of intussusception in children. Surgery, 42(4): 469–477.
Other Works Consulted
- Chu A, et al. (2011). Ileus, adhesions, intussusception, and closed-loop obstructions. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1287–1291. Philadelphia: Saunders.
- Densmore JC, Lal DR (2011). Intussusception. In CD Rudolph et al., eds., Rudolph’s Pediatrics, 22nd ed., pp. 1428–1429. New York: McGraw-Hill.
- Hackam DJ, et al. (2015). Pediatric surgery. In FC Brunicardi et al., eds., Schwartz’s Principles of Surgery, 10th ed., pp. 1597–1649. New York: McGraw-Hill Education.
- Justice FA, et al. (2006). Intussusception: Trends in clinical presentation and management. Journal of Gastroenterology and Hepatology, 21(5): 842–846.
- Kharbanda AB, Sawaya RD (2011). Acute abdominal pain in children. In JE Tintinalli, ed., Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7th ed., pp. 839–848. New York: McGraw-Hill.
Current as of: December 12, 2018
Author: Healthwise Staff
Medical Review:John Pope, MD, MPH – Pediatrics & Kathleen Romito, MD – Family Medicine & Brad W. Warner, MD – Pediatric Surgery, Critical Care Medicine
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