Intussusception usually occurs in children between 3 months and 3 years of age, but affects boys more than girls though experts do not know why. It is a serious disorder in which the small intestine folds or telescopes in on itself.

Think of the small intestine as the sleeve of a wool sweater and a human arm as the food that passes through it. If the sleeve is laid out straight, then it is easy for the arm to pass through the sleeve from the shoulder to the cuff and come out the other side. However, if the sleeve is bunched in at the sides, or if the cuff “telescopes” inward toward the shoulder, then it is more difficult for the arm to pass through the sleeve.

When this “bunching” or “telescoping” occurs in the small intestine, it is harder for fluid or food to pass through the intestine. This can lead to a partial or full intestinal blockage, and the ensuing buildup of food and fluid cuts off the blood supply to other parts of the intestine while causing swelling both in the intestine and the surrounding area.

Causes

Though the exact cause of intussusception in children is unknown, trigger factors like viral infections, stomach flu, cancerous tumors in the intestine, and non-cancerous intestinal growths such as polyps have been associated with the condition. Intussusception is more common during seasons like spring and fall because children generally catch upper respiratory infections during these times. It also occurs when children are introduced to solid foods for the first time, which may cause swelling of lymph tissue in the intestine.

Symptoms

Children with intussusception may experience intermittent pain, which can last about 15 to 20 minutes at a time. Parents may notice a swollen and distended “lump” in their child’s abdomen. Due to the severe abdominal pain, infants or toddlers with intussusception may pull their legs towards their chest and cry loudly.

In addition, the child may vomit bile (the vomit will appear greenish-yellow if this is the case) and experience diarrhea – both of which can lead to dehydration. The child’s stool will have a currant jelly-like appearance, which indicates that there is blood and mucus present. High fever, drowsiness, and irritability are also symptoms of intussusception.

Complications

If left untreated, intussusception can cause severe complications which can increase in severity the longer that treatment is delayed. If a child is treated within the first 24 hours after intussusception symptoms have appeared, he or she usually recovers completely without complications. However, delaying treatment can lead to perforation of the intestine, irreversible tissue damage, infection of intestinal tissue, and even death.

If the intestine becomes perforated, it can cause an infection in the lining of the abdominal cavity known as peritonitis, which is a life-threatening condition. Symptoms of peritonitis include abdominal swelling and pain, excessive thirst, fever, and low urine output.

When to Call the Doctor

It is vital that parents contact medical personnel as soon as they notice symptoms of intussusception. It is possible that the child could go into anaphylactic shock, which is characterized by cold and clammy skin, blank eyes, slow breathing, rapid and weak pulse, pale or grey colored skin, profound listlessness, and possibly unconsciousness. In this case, parents must rush the child to emergency care or call 911 for help.

Intussusception can usually be eliminated if it is diagnosed quickly. But the chances of complications multiply if the condition if left untreated. So parents should not feel the least bit concerned about overreacting if they suspect that their child is suffering from intussusception. It is better to notify the doctor and be wrong than to forgo medical treatment and risk severe harm to their child.

Diagnosis

To diagnose intussusception, the doctor may look for a distended abdomen or feel for a lump in the abdominal area during a perfunctory physical examination. Then he or she may perform blood and urine tests, as well as a fecal occult test to check for blood in the child’s stools.

In a procedure known as a CT (computerized tomography) scan, cross-sectional X-ray images of the abdomen are taken to search for any intestinal obstructions or perforations which may be caused by intussusception. Similarly, an ultrasound of the abdomen can be conducted where high frequency sound waves are used to obtain abdominal images.

There is also a procedure called an air (or barium) enema which can be performed in conjunction with a CT scan. The doctor sends air (or liquid barium as a last resort) into the colon through the rectum of the child to make the X-rays clearer. Sometimes, the enema itself will clear the intussusception, in which case no further treatment is required.

Treatment

Intussusception is treated as a medical emergency in order to avoid infection, anaphylactic shock, or dehydration. Once the patient is brought to the hospital, intravenous fluids are administered to stabilize his or her condition. Then a nasogastric tube, which is a tube that runs from the child’s nose to his or her stomach, is inserted in order to decompress the intestines.

If an air or barium enema does not cure the intussusception, then surgery is recommended. A surgeon would then clear the intestinal obstruction and remove any intestinal tissue that has died due to a lack of blood supply.