Intussusception - children
Intussusception is the sliding of one part of the intestine into another.
This article focuses on intussusception in children.
Causes, incidence, and risk factors
Intussusception is caused by part of the intestine being pulled inward into itself. This can block the passage of food through the intestine. If the blood supply is cut off, the segment of intestine pulled inside can die.
The pressure created by the walls of the intestine pressing together causes:
- Decreased blood flow
The intestine can die, and the patient can have significant bleeding. If a hole occurs, infection,
The cause of intussusception is not known, although viral infections may be responsible in some cases. Sometimes a lymph node, polyp, or tumor can trigger the problem. The older the child, the more likely such a trigger will be found.
Intussusception can affect both children and adults, although most cases occur in children ages 6 months - 2 years. It affects boys four times as often as girls.
The first sign of intussusception is usually sudden, loud crying caused by
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
- Shock (
palecolor, lethargy, sweating)
- Stool mixed with blood and mucus
Signs and tests
Your doctor will perform a thorough examination, which may reveal a
Tests may include:
- Air or contrast
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
If these treatments are unsuccessful, the child will need surgery. The bowel tissue can usually be saved, but any dead tissue will be removed.
The outcome is good with early treatment. There is a risk the condition will come back.
A hole (perforation) is a serious complication due to risk of infection. If not treated, intussusception is almost always fatal for infants and young children.
Calling your health care provider
Intussusception is an emergency. Call your health care provider immediately, then call 911 or go immediately to the emergency room.
Chu A, Liacouras CA. Ileus, adhesions, intussusceptions, and closed-loop obstructions. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 325.
Peterson MA. Disorders of the Large Intestine. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 93.