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Intussusception - X-ray
Intussusception - X-ray


Digestive system organs
Digestive system organs


Intussusception - children

Definition:

Intussusception 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.

The cause of intussusception is not known. Conditions that may lead to the problem include:

  • Viral infection
  • Nodule on the lymph node
  • Polyp or tumor

The reason for the problem is more likely to be found in older children.

Intussusception can affect both children and adults. However, most cases occur in children ages 6 months - 2 years. It affects boys four times as often as girls.



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.

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)
  • Stool mixed with blood and mucus
  • Vomiting


Exams and Tests:

Your doctor will perform a thorough exam, which may reveal a mass in the abdomen . There may also be signs of dehydration or shock.

Tests may include:



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.

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.



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 promptly. If not treated, intussusception is almost always fatal for infants and young children.



When to Contact a Medical Professional:

Intussusception is an emergency. Call your health care provider right away, then call 911 or go immediately to the emergency room.



References:

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.

Hostetler MA. Gastrointestinal disorders. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Mosby Elsevier; 2013:chap 172.




Review Date: 5/14/2014
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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