Intussusception
Overview
The digestive system processes and uses the nutrients in food. The intestines are a part of the digestive tract that runs from the mouth to the anus. If you spread out the intestines end-to-end, they would stretch several feet long. In the body, the intestines are folded tightly and take up only part of the abdomen.
Intussusception occurs when one part of the intestine telescopes (slides) into a nearby part of the intestine, creating unusual folds. These folds block food or liquid from passing through the intestine normally and can cut off blood flow. Intussusception is a serious condition — if not properly diagnosed and treated, it can lead to complications, including:
Gangrene (death of intestine tissue)
Infection
Perforation (tear) in the intestine
Symptoms of Intussusception
Symptoms and signs of this condition may include:
Abdominal pain that comes and goes (intermittent)
Diarrhea
Fatigue
Fever
Lump or swelling in the abdomen
Pulling knees to chest (due to abdominal pain)
Stool mixed with mucus and blood
Vomiting
When to see a doctor
Take your child to the emergency room right away if they experience any of the above symptoms. Intussusception is considered a medical emergency — it is the most common serious abdominal condition in children younger than 2.
Causes of Intussusception
In most cases, experts don’t know what causes intussusception in children. In rare cases, it may be a virus affecting the digestive tract that causes intussusception.
Who’s at risk
For unknown reasons, male children are more at risk for intussusception than female children. Other factors that can increase your child’s risk for developing this condition include:
Being between the ages of 6 months and 3 years
Congenital (present at birth) intestinal conditions, such as malrotation of the bowel
Family member (such as a sibling) having intussusception
Diagnosis of Intussusception
Your child’s doctor will begin to diagnose intussusception by doing a complete physical exam. They will ask questions about your child’s personal and family medical history. From there, your child will take one or more of the following tests to confirm this condition:
Abdominal X-ray. Your child’s doctor may use X-ray imaging to obtain detailed pictures of your child’s abdomen and intestines. For this test, your child may need to take barium (a silver-colored liquid) that shows up on the image and helps the doctor get a clearer picture of the intestines and problem.
Ultrasound. This test uses sound waves to capture detailed images of the inside of your child’s body that will help the doctor pinpoint the area of the folded intestine.
Barium enema. This test involves delivering barium (a silver-colored liquid) directly into the rectum to help the doctor see issues. During this test, your child’s doctor captures detailed images of the intestine that will help the doctor pinpoint the area of the folded intestine.
Treatments for Intussusception
If your child’s doctor diagnoses intussusception, they may order another diagnostic imaging test that is also a form of treatment, called an air contrast enema. This will be performed by the radiologist and is often effective in returning the intestines into their usual place. If the imaging procedure is successful, your child can be observed in the emergency department (ED). It is possible for intussusception to happen again following this treatment, so your child will need to return to the ED if the symptoms reoccur.
If doctors cannot fix the intussusception with the enema, your child will need surgery to correct it. During the procedure, your child’s surgeon will reposition the intestine that has slid out of place. This minimally invasive surgery usually involves small incisions (cuts) and a short recovery time.
During the surgery, your child will be under general anesthesia (fully asleep). To begin, the surgeon will make tiny incisions (cuts) on your child’s abdomen. They will then insert a tiny surgical camera into one incision and thin surgical tools into the others.
Your child’s surgeon will use a monitor through the tiny camera to move the intestine back into place. Your child will likely receive fluids through their vein via an intravenous (IV) line before surgery. These fluids hydrate your child and help prevent dehydration while they are unable to eat. Your child may also need a nasogastric (NG) tube running from their nose to their stomach to prevent gas buildup.
After the procedure, your child will spend several hours in a recovery area for close monitoring while the effects of anesthesia wear off. Your child will likely stay one night in the hospital after the procedure. Your child will need to rest for at least one week and then limit physical activity for a couple more weeks after that. Your child should be fully recovered from the procedure in about four to six weeks.
Most children who receive prompt (typically within 24 hours) treatment for intussusception fully recover and do not have any long-term effects or restrictions. If treatment is delayed for any reason, damage to the intestine can occur. In this case, the child’s digestive process can be affected long term and they may need supplemental nutrition. This supplemental nutrition is called total parenteral nutrition (TPN) and is delivered through a vein (intravenous) to bypass the intestine. Your child’s surgeon will provide you with specific instructions based on your child’s unique needs and situation.
Contact Us
If you suspect that your child may have Intussusception, make an appointment with an Orlando Health pediatrician today so your child can start on the road to improved health.
