Intussusception – children
Abdominal pain in children - intussusceptionIntussusception is the sliding of one part of the intestine into another.
This article focuses on intussusception in children.
Causes
Intussusception is caused by part of the intestine being pulled inward into itself.
The pressure created by the walls of the intestine pressing together causes:
- Decreased blood flow
- Irritation
- Swelling
Intussusception can block the passage of food through the intestine. If the blood supply is cut off, the segment of intestine pulled inside can die. Heavy bleeding may also occur. If a hole develops, infection, shock, and dehydration can take place very rapidly.
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much...
The cause of intussusception is not known. Conditions that may lead to the problem include:
- Viral infection
- Enlarged lymph node in the intestine
- Polyp or tumor in the bowel
Intussusception can affect both children and adults. It is more common in boys. It usually affects children ages 5 months to 3 years.
Symptoms
The first sign of intussusception is very often sudden, loud crying caused by abdominal pain. The pain is colicky and not continuous (intermittent), but it comes back often. The pain will get stronger and last longer each time it returns.
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
An infant with severe abdominal pain may draw the knees to the chest while crying.
Other symptoms include:
- Bloody, mucus-like bowel movement, sometimes called a "currant jelly" stool
- Fever
- Shock (pale color, lethargy, sweating)
Pale
Paleness is an abnormal loss of color from normal skin or mucous membranes.
Read Article Now Book Mark ArticleLethargy
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Stool mixed with blood and mucus
- Vomiting
Exams and Tests
Your health care provider will perform a thorough exam, which may reveal a mass in the abdomen. There may also be signs of dehydration or shock.
Mass in the abdomen
An abdominal mass is swelling in one part of the belly area (abdomen).
Tests may include:
- Abdominal ultrasound
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Abdominal x-ray
Abdominal x-ray
An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the liver, spleen, stomach, and intestines. Wh...
ImageRead Article Now Book Mark Article - Air or contrast enema
Enema
Barium enema is a special x-ray of the large intestine, which includes the colon and rectum.
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Treatment
The child will first be stabilized. A tube will be passed into the stomach through the nose (nasogastric tube). An intravenous (IV) line will be placed in the arm, and fluids will be given to prevent dehydration.
In some cases, the bowel blockage can be treated with an air or contrast enema. This is done by a radiologist skilled with the procedure. There is a risk of bowel tearing (perforation) with this procedure.
Bowel blockage
Intestinal obstruction is a partial or complete blockage of the bowel. The contents of the intestine cannot pass through it.
The child will need surgery if these treatments do not work. The bowel tissue can very often be saved. Dead tissue will be removed.
Antibiotics may be needed to treat any infection.
Intravenous feeding and fluids will be continued until the child has a normal bowel movement.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
Outlook (Prognosis)
The outcome is good with early treatment. There is a risk this problem will come back.
When a hole or tear in the bowel occurs, it must be treated right away. If not treated, intussusception is almost always fatal for infants and young children.
When to Contact a Medical Professional
Intussusception is a medical emergency. Call 911 or the local emergency number, or go to the emergency room right away.
References
Abdulhai S, Ponsky T. Intussusception in infants and children. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 51.
Hu YY, Jensen T, Finck C. Surgical conditions of the small intestine in infants and children. In: Yeo CJ, ed. Shackelford's Surgery of the Alimentary Tract. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 83.
Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Ileus, adhesions, intussusception, and closed-loop obstructions. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 359.
Maloney PJ. Pediatric gastrointestinal disorders. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 166.
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Colonoscopy - illustration
There are 3 basic tests for colon cancer; a stool test (to check for blood), sigmoidoscopy (inspection of the lower colon), and colonoscopy (inspection of the entire colon). All 3 are effective in catching cancers in the early stages, when treatment is most beneficial.
Colonoscopy
illustration
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Intussusception - X-ray - illustration
This abdominal X-ray shows an intestinal condition in which a loop of bowel has slipped into another section of bowel (intussusception), causing swelling, reduced blood flow, obstruction, and tissue damage. Intussusception requires emergency treatment (barium enema or surgery) to prevent intestinal tissue death (necrosis), intestinal perforation, peritonitis, and death.
Intussusception - X-ray
illustration
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Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
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Colonoscopy - illustration
There are 3 basic tests for colon cancer; a stool test (to check for blood), sigmoidoscopy (inspection of the lower colon), and colonoscopy (inspection of the entire colon). All 3 are effective in catching cancers in the early stages, when treatment is most beneficial.
Colonoscopy
illustration
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Intussusception - X-ray - illustration
This abdominal X-ray shows an intestinal condition in which a loop of bowel has slipped into another section of bowel (intussusception), causing swelling, reduced blood flow, obstruction, and tissue damage. Intussusception requires emergency treatment (barium enema or surgery) to prevent intestinal tissue death (necrosis), intestinal perforation, peritonitis, and death.
Intussusception - X-ray
illustration
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Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
Review Date: 2/17/2024
Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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