Intussusception

What is intussusception?

Intussusception is a serious problem with the intestine. It occurs when one part of the intestine slides into another section. This causes the intestine to fold and become blocked. This prevents the passage of food through the intestine.

Intussusception can occur in adults. However, it is more common in infants and young children. It is a medical emergency. If left untreated, it may cause severe complications. These could include infection or even death.

Symptoms

The first sign of intussusception is severe abdominal pain. It could last for 15 to 20 minutes. It often gets worse as time goes on. Other signs your child may have intussusception include:

• Swelling in the abdomen
• Vomiting
• Irritability
• Bloody, mucus-like stools
• Fever
• Signs of shock (pale color, lack of energy, sweating)

What causes intussusception?

There is no known cause for most cases of intussusception. Rarely, some conditions could lead to intussusception. These include:

• Appendicitis
• A viral infection
• A tumor or polyp (a growth inside the intestine)

Intussusception is the most common cause of intestinal blockage in children between 3 months and 3 years of age. Most cases of intussusception occur in babies younger than 1 year of age. For unknown reasons, boys are affected more often than girls. Intussusception also occurs in older children and adults. However, there are fewer cases in these groups.

How is intussusception diagnosed?

Your doctor will ask questions about your child’s symptoms and perform a physical exam. They may be able to feel the part of the intestine that is tender. Your doctor might order an ultrasound of the intestine. This imaging test uses sounds waves to create pictures to see if intussusception is causing your child’s symptoms. Your doctor may also order an abdominal X-ray.

Can intussusception be prevented or avoided?

Since the there is no known cause, there is no way to prevent or avoid intussusception.

Treatment

In many cases, intussusception is corrected with an air enema. Your doctor will use a small tube to fill your child’s rectum with air. The air pushes the folded intestine back into place. This clears the blockage. Your doctor may also want to get an X-ray of your child’s abdomen to see if the procedure was effective. Antibiotics can be used to treat an infection but are usually not needed. Sometimes the intestine doesn’t stop collapsing or it is caused by a tumor or polyp. In those cases, surgery may be necessary to correct the problem. Your child may need intravenous fluid to stay hydrated until treatment is complete.

Because intussusception is a medical emergency, seek medical help immediately if your child has symptoms of intussusception. When left untreated, intussusception may cause severe complications.

Living with intussusception

With prompt treatment, most children recover completely from intussusception. Occasionally, complications such as infection can occur if the intussusception is not treated quickly. If this happens, part of the bowel must be surgically removed. It is important to see your doctor right away if your child has symptoms of intussusception.

Intussusception sometimes returns, usually within 3 days. Keep close watch for returning symptoms.

Questions to ask your doctor

• What is an air enema?
• Could the intussusception happen again?
• What can I do to make my child more comfortable before surgery?
• What risks are there for my child who is having surgery?
• Will my child be able to live a normal life after surgery?
• If one of my children has intussusceptions, could the others develop it, as well?
• How will you know if my child needs surgery?

Resources

National Institutes of Health, MedlinePlus: Intussusception – children