Intussusception in Children
What is intussusception in children?
Intussusception is a serious problem in the intestine. It occurs when 1 part of the
intestine slides inside another part. The intestine then folds into itself like a
telescope. This creates a blockage or obstruction. It stops food that is being digested
from passing through the intestine.
Intussusception is the most common cause of intestinal blockage in children between
ages 3 months and 3 years. It's rare in newborn babies. But it can also occur in older
children, teens, and adults.
Intussusception is a medical emergency. It's the most common abdominal emergency in
early childhood. If not treated, it can cause infection or even death.
What causes intussusception in a child?
Experts don’t know what causes intussusception. It may occur more often in children
who have a family history of the disorder.
Experts have found a link in some cases with other conditions. These include viral
infection, abdominal or intestinal tumors or masses, appendicitis, parasites, celiac
disease, cystic fibrosis, and Crohn's disease.
What are the symptoms of intussusception in a child?
Intussusception is a medical emergency. If you think your child may have the disorder,
get medical care right away.
Each child’s symptoms may vary. The most common symptom is sudden, loud crying. This
is caused by sudden, severe belly (abdominal) pain in an otherwise healthy child.
This belly pain occurs often. At first it may seem to be colic. Infants or children
may strain, draw their knees up, act very irritable, and cry loudly. Your child may
feel better and be playful between bouts of pain. Or your child may become tired and
weak from crying.
Other symptoms include:
Symptoms of intussusception may seem like other health problems. See your child's
healthcare provider for a diagnosis.
How is intussusception diagnosed in a child?
Your child’s healthcare provider will take a health history and give your child a
physical exam. Imaging studies are also done to check the belly (abdominal) organs.
These tests can be very upsetting to your child. As much as possible, and in an age-appropriate
manner, explain to your child what will be happening and why it's happening before
the procedure. These tests may include:
Abdominal X-ray. A diagnostic test that may show intestinal blockage.
Ultrasound. A diagnostic imaging method that uses high frequency sound waves and a computer to
create images of blood vessels, tissues, and organs. Ultrasounds are used to view
organs as they work and to check blood flow through various vessels.
Upper GI series or barium swallow. This test looks at the organs of the top part of the digestive system. It checks the
food pipe (esophagus), the stomach, and the first part of the small intestine (duodenum).
Your child will swallow a metallic fluid called barium. Barium coats the organs so
that they can be seen on an X-ray. Then X-rays are taken to check the digestive organs.
Barium enema or lower GI series. This is an X-ray exam of the rectum, the large intestine, and the lower part of the
small intestine. Your child will be given a metallic fluid called barium. Barium coats
the organs so they can be seen on an X-ray. The barium is put into a tube and inserted
into your child’s rectum as an enema. An X-ray of the belly will show if there are
any narrowed areas called strictures, any blockages, or other problems. In some cases,
the intussusception fixes itself during this test. The intestine may go back into
place on its own. This can happen because of the pressure put on the intestine while
the barium is inserted.
How is intussusception treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
Sometimes intussusception will repair itself while a child has a barium enema. In
many cases, the healthcare provider can correct the problem by giving an air enema
or saline enema. This is done by placing a small tube in your child's rectum. The
healthcare provider uses ultrasound or X-rays (fluoroscope) to help place the tube.
Air is inserted in the tube. The air may help move the intestine back into its normal
position. But if your child is very ill with an abdominal infection or other problems,
the provider may choose not to do this.
Your child will need surgery if the intussusception is not repaired with a barium
enema. Your child will also need surgery if they are too ill to have a barium enema,
saline enema, or air enema. For the surgery, your child will be given anesthesia so
they may comfortably sleep during the procedure. The surgeon will make a cut (incision)
in the belly. The surgeon will find the intussusception and push the parts of the
intestine back into place. The intestine will be checked for damage. If any sections
are not working correctly, they will be removed.
If your child’s intestine is damaged and the part removed is small, the 2 sections
of healthy intestine will be sewn back together.
In very rare cases, a large amount of intestine may be removed. This happens if the
damaged section of intestine is large. In this case, surgery can’t link together the
parts of the intestine that remain after the damaged section is removed. An ileostomy may
be done so that the digestive process can continue. With an ileostomy, the 2 remaining
healthy ends of intestine are brought through openings in the belly. Stool will pass
through the opening (stoma). It will then collect in a bag on the outside of the body.
The ileostomy may be short-term. Or, in very rare cases, it may be long-lasting or
permanent. It depends on how much intestine was removed.
What are possible complications of intussusception in a child?
Intussusception is a medical emergency. It's a life-threatening illness. If not treated,
it can cause serious problems such as:
The death of intestinal tissue
A severe abdominal infection called peritonitis
A very serious illness called sepsis that occurs when the body has an overwhelming
response to an infection
Shock, which refers to life-threatening changes in blood pressure, pulse, and breathing
How can I help my child live with intussusception?
If not treated, intussusception is a life-threatening disorder.
Your child’s long-term outlook depends on how much damage was done to the intestines.
Most children will have no long-term complications of intussusception if treated correctly.
Children who had the damaged part of their intestine removed may have long-term problems.
Removing a large part of the intestine can affect the digestive process. These children
may need to eat and drink more to get the nutrients and fluids that they need.
Talk with your child's healthcare provider about your child’s prognosis.
When should I call my child's healthcare provider?
Intussusception is a medical emergency. Call your child's healthcare provider if your
Sudden, severe belly (abdominal) pain
Bloody or red jelly-like stools
Other signs of severe illness
Key points about intussusception in children
Intussusception is a serious problem in the intestine. It's a medical emergency.
It occurs when 1 part of the intestine slides inside another part. The intestine then
folds into itself like a telescope.
This creates a blockage or obstruction. It stops food that is being digested from
passing through the intestine.
In many cases, it can be corrected during diagnostic testing. Sometimes it goes away
on its own. In some cases, surgery may be needed.
If not treated, intussusception can be life-threatening.
Intussusception can happen again, especially if it's not treated correctly or with
surgery the first time.
Tips to help you get the most from a visit to your child’s healthcare provider:
Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new directions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are and when they should be reported.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.