- When to Seek Care
- Risk Factors
- Symptoms & Signs
Facts you should know about intussusception
- Intussusception is the infolding (telescoping) of one segment of the intestine within another.
- Intussusception usually results in a blockage of the intestine.
- Intussusception occurs primarily in infants (boys more often than girls) but can also occur in adults and older children.
- The primary symptoms of intussusception include abdominal pain and vomiting.
- Early diagnosis and treatment of intussusception are essential to save the intestine and the patient.
What is intussusception?
Intussusception is the telescoping of one segment of intestine into another adjacent distal ("downstream") segment of the intestine. (The term "intussusception" is pronounced "in-tuh-suh-sep-shun" with the accent on the "in." It comes from the Latin "intus", within + "suscipere", to receive = to receive within). Common misspellings of intussusception include: intususception, intussuseption, intersusception.
Intussusception is the most common cause of intestinal obstruction in children between 3 months and 5 years of age. It is extremely rare in children under 3 months of age or in older children and adults.
What happens during intussusception?
During intussusception, a segment of bowel (intussusceptum) telescopes into a more distal segment (intussuscipiens), and drags the associated mesentery, vessels, and nerves with it. This results in compression of the veins, followed by swelling of the region leading to obstruction and a subsequent decrease in blood flow to the affected part of the intestine. Most cases affect the ileocolic region of the intestine (where the small intestine meets the large intestine).
The compression of blood vessels in the involved intestine reduces the supply of blood to the affected intestine. If the blood supply is greatly reduced, the involved intestine may swell, causing an obstruction, or even die (become gangrenous) and bleed. It also may rupture and lead to abdominal infection and shock.
Is intussusception an urgent problem?
Intussusception is an emergency and requires immediate attention.
Who is at greatest risk for intussusception?
Most cases of intussusception occur in children between 5 months and 1 year of age. Boys develop the condition two times more often than girls. Intussusception can also occur in adults and older children, although it is uncommon.
What causes intussusception?
The causes of intussusception are not fully known. Most cases in young children are idiopathic, (meaning the cause is unknown), although some viral and bacterial infections of the intestine may possibly contribute to intussusception in infancy.
Intussusception is very rare in older children and adults. In this population, the causes are believed to be due to polyps or tumors, which are often referred to as the "lead point" of the intussusception.
Why is rapid diagnosis of intussusception important?
Early diagnosis and treatment of intussusception is essential in order to prevent injury to the intestine and the associated sequelae, including surgical removal of the bowel, sepsis, and even death.
What are the symptoms of intussusception?
Most describe the symptoms of intussusception as a triad of colicky abdominal pain, bilious vomiting, and "currant jelly" stool.
The primary symptom of intussusception is described as intermittent crampy abdominal pain. This is often called "colicky pain." Intussusception in an infant usually starts with the infant suddenly crying very loudly, as if in great pain. The infant intermittently draws the knees up to the chest while crying. This reaction is caused by the abdominal pain which recurs frequently and increases in intensity and duration. These intermittent painful episodes are believed to be caused by the telescoping of the bowel and resultant compression of blood vessels and nerves.
In addition to the abdominal pain, most children will also have episodes of vomiting associated with the pain. This vomiting is usually not associated with eating and may be bilious (yellow-green colored)
Some affected individuals who do not seek early medical attention may pass "currant jelly stool". This is stool that is bloody and mucousy and may be a sign that the affected bowel has lost its blood supply and that the bowel may be necrotic (non-viable).
As the condition progresses, the infant becomes may become weaker and develop additional symptoms, including those associated with shock, such as paleness, lethargy, and even fever, though these are not an integral part of the associated "triad."
Thankfully, most cases are diagnosed early.
- Baby Boys 'Talk' More During First Year Compared to Girls
- U.S. Teen Birth Rate Hits Another Historic Low
- Cancer Survivors Who Keep Smoking Have Double the Risk for Heart-Related Death
- Need a Prostate Exam? Here's What to Expect
- Prostatitis: What It Is, Symptoms, Causes & Treatment
- More Health News »
How do medical professionals diagnose intussusception?
The history of abdominal pain and vomiting as described above, may suggest the diagnosis of intussusception. Additionally, the examining doctor may feel an abdominal "sausage-shaped" mass (the intussusception itself) or upon auscultation with a stethoscope, may hear diminished or absent bowel sounds. Lab tests are usually not helpful, although plain abdominal X-rays can reveal signs of an intestinal obstruction, including air-fluid levels, decreased gas, and unexplained masses, usually seen in the right lower quadrant of the abdomen. Ultrasound and CT scans are generally not required to make the diagnosis.
A barium, water-soluble contrast or air enema is considered both diagnostic and therapeutic in the management of intussusception. This radiologic procedure involves the introduction of the contrast into the lower intestine. If an intussusception is present, it will be seen during the imaging. Often just the introduction of the contrast will reduce the telescoped bowel to its normal position and shape. In these cases, there is a high risk of for re-intussusception in the first 24 hours following the enema, though, less commonly, recurrence may be seen several days and even months later.
Is it necessary to operate when there is intussusception?
The treatment of intussusception may or may not require surgery. In some cases, the intestinal obstruction can be reversed with an enema. The enema carries a risk of intestinal rupture and cannot be done if the bowel has already perforated. The procedure also requires the availability of a surgeon, in case the patient's bowel ruptures or the intussusception cannot be reduced.
If the intestinal obstruction cannot be reversed by an enema, surgery is necessary to reverse the intussusception and relieve the obstruction. If a portion of the intestine has become gangrenous, it must be removed. After surgery, intravenous feeding and fluids are continued until normal bowel movements resume. Because of the risk of recurrence, patients who are successfully reduced by enema usually are admitted for observation during the first 24 hours post procedure, and have no ill effects. Recently, research has suggested that a select population of the children may be observed for shorter periods of time (6 hours) after undergoing reduction of the intussusception by enema, but currently, most patients stay the full 24 hours.
What is the prognosis (outlook) for patients with intussusception?
The outlook for intussusception is usually good with early diagnosis and treatment. Early detection and treatment are paramount.
Subscribe to MedicineNet's Children's Health & Parenting Newsletter
Health Solutions From Our Sponsors
Chien M et.al. Management of the child after Enema-Reduced Intussusception: hospital or home; Journal of Emergency Medicine; 2011, May. doi:10.1016/j.jemermed.2012.02.030
Top Intussusception Related Articles
Abdominal PainAbdominal pain can have many causes that range from mild to severe. Some of these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn's disease, ulcerative colitis, gallbladder disease, liver disease, and cancers. Signs and symptoms of the more serious causes include dehydration, bloody or black tarry stools, severe abdominal pain, pain with no urination or painful urination. Treatment for abdominal pain depends upon the cause.
FeverAlthough a fever technically is any body temperature above the normal of 98.6 F (37 C), in practice, a person is usually not considered to have a significant fever until the temperature is above 100.4 F (38 C). Fever is part of the body's own disease-fighting arsenal; rising body temperatures apparently are capable of killing off many disease-producing organisms.
AscariasisA parasite names Ascaris lumbricoides causes ascariasis. Symptoms and signs include abdominal pain, abdominal swelling, nausea, vomiting, fever, and passage of parasites and eggs in the stool. Treatment involves taking oral medications for one to three days.
Barium EnemaThe barium enema and double contrast barium enema are used to define normal and abnormal anatomy of the colon and rectum. A lower GI series, also known a barium enema, barium enema procedure, barium enema X-ray, or double-contrast barium enema, is an X-ray test in which a white liquid, called barium, is infused through a catheter (tube) inserted through the anus and into the rectum until it fills the large bowel (colon).
Blood in the Stool (Rectal Bleeding, Hematochezia)Blood in the stool or rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Common causes include anal fissures, hemorrhoids, diverticulitis, colitis, Crohn's disease, colon and rectum polyps, and cancer. The color of the blood in the stool may provide information about the origin of the bleeding. The color of stool with blood in it may range from black, red, maroon, green yellow, gray, or white, and may be tarry, or sticky. Treatment of blood in the stool depends on the cause.
Children's HealthChildren's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health, and community health.
Colic in BabiesColic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.
Nausea and VomitingNausea and vomiting are symptoms of many conditions including motion sickness, pregnancy, emotional stress, gallbladder disease, and other illnesses. Learn about causes, treatment, and when to be concerned.
Crying & Colic SlideshowLearn top parenting tricks for calming crying, colicky, and fussy newborns and babies.
RotavirusRotavirus is the most common cause of severe diarrhea among infants and children throughout the world. Almost all children have become infected with rotavirus by their third birthday. Repeat infections with different viral strains are possible, and most children have several episodes of rotavirus infection in the first years of life. Children between the ages of six and 24 months are at greatest risk for developing severe disease from rotavirus infection. Rotavirus symptoms include: fever, vomiting, watery diarrhea, and abdominal pain. Rotavirus infection can be associated with severe dehydration in infants and children.
Stool Color, Changes, Texture and FormStool color changes can very from green, red, maroon, yellow, white, or black. Causes of changes of stool color can range from foods a person eats, medication, diseases or conditions, pregnancy, cancer, or tumors. Stool can also have texture changes such as greasy or floating stools. Stool that has a uncharacteristically foul odor may be caused by infections such as giardiasis or medical conditions.
The Digestion Process (Parts, Organs, and Functions)Digestion is the complex process of turning the food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food. Learn more about digestion and the body parts that make it possible, including the mouth, pharynx, esophagus, stomach, small intestine, colon, rectum, anus, pancreas, liver, and gallbladder.