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Intussusception In Children: Symptoms, Causes And Diagnosis

Intussusception refers to a condition where a part of the intestine telescopes into its adjacent part. Intussusception in children is a serious condition that could eventually lead to intestinal obstruction. It may even interfere with intestinal blood circulation, increasing the risk of infections and tissue damages.

It is a common occurrence in children below three years. Though the exact cause of intussusception is unknown, you must seek immediate medical care to avoid severe life-threatening complications.

Read this post to learn about the symptoms, risk factors, diagnosis, and treatment options for intussusception in children.

Symptoms And Signs Of Intussusception In Children

An episode of sudden abdominal pain is a common sign of the condition. The pain may last up to 20 minutes in the initial stages and often resolves and repeats. Pain may last longer and frequently occur over time.

Other symptoms and signs of intussusception may include (1):

• Red currant jelly-like appearance of stool since it is mixed with blood and mucus
• Vomiting
• Tiredness
• Fever
• Diarrhea
• Lump in the abdomen

Not all children develop obvious pain and other symptoms of intussusception. If your child has any symptoms and signs of intussusception, seek emergency medical care.

Causes And Risk Factors Of Intussusception In Children

Intussusception is a condition where a part of the intestine slides into another, similar to how a collapsible telescope folds. Abnormal growth, such as a polyp or a tumor, could be a lead point for intussusception. Telescoping may also occur during the peristalsis (wave-like intestinal contraction).

A viral infection could be a trigger, and children with flu-like symptoms may develop intestinal telescoping. Meckel’s diverticulum (bulging of a part of the intestine) is also identified as a risk factor. However, it is not known how these conditions lead to intussusception (2).

The following are the various other risk factors of intussusception in children.

• Age between six months and three years
• Male gender
• History of intussusception
• Family history of intussusception
• Congenital anomalies of the intestines, such as malrotation

Intussusception may not develop in all children with these conditions and risk factors. 

Possible Complications Of Intussusception In Children

Interruption of blood supply in the affected part of the intestine is the most common complication of intussusception. If not treated on time, the loss of blood supply may result in permanent damage (tissue death) of intestinal tissue.

Tissue death may lead to perforation or a tear in the intestinal wall, causing its contents to leak into the abdominal cavity. This may result in peritonitis (inflammation of the abdominal cavity lining), a life-threatening condition requiring emergency medical attention (3).

Signs and symptoms of peritonitis may include:

• Abdominal swelling
• Abdominal pain
• Fever

You may also notice the following signs if the peritonitis causes shock (abnormal changes in the pulse, breathing, blood pressure, and other body functions).

• Pale or gray skin
• Cold, clammy skin
• Agitation
• Anxiety
• Rapid or weak pulse
• Rapid or shallow breathing
• Lack of energy

Children with shock can be conscious or unconscious. If you notice any signs of shock, seek emergency medical care regardless of the level of consciousness. 

Diagnosis Of Intussusception In Children

Doctors may listen to the history of complaints and look for physical signs of intussusception or its complications. In most cases, a sausage-shaped lump is palpated in the abdomen. The presence of rebound tenderness or Shyotkin-Blumberg sign (pressure followed by sudden release causes pain) indicates peritonitis.

The following tests are ordered to confirm the diagnosis (2).

• Abdominal imaging, including ultrasound, computed tomography (CT) scan, or X-ray, may help identify the intussusception and its complications, such as perforation.

• Barium or air enema may also enhance the visualization of the large intestine (colon).

The barium or air enema is given through the rectum and may help fix the telescoped intestine into the normal position. This procedure is contraindicated in cases of perforation since the content could leak into the abdominal cavity. Prompt emergency medical care before the onset of complications may help resolve the condition without surgical procedures. 

Treatment For Intussusception In Children

Intussusception treatment is usually given in emergency medical care. The treatment goal is to avoid shock and dehydration and prevent infections, which may occur due to the death of the intestinal tissue.

The following treatment options are given for intussusception in children (4).

1. Intravenous (IV) fluids are given in initial care.

2. A nasogastric tube (NG) is inserted from the nose into the stomach and then the intestine to decompress the intestines.

3. Barium or air enema is performed for diagnosis and treatment. Some children may have a recurrence of intussusception even after barium or air enema treatment, and may require repeated procedures.

4. If the enema fails or in cases of perforation, surgical treatment is recommended. The surgery could involve relieving the folded intestine, clearing any obstruction, and removing dead tissue if present.

In some cases, intussusception may go away without any treatment.

Intussusception in children is a severe complication that affects children under three years and is characterized by acute stomach pain lasting up to 20 minutes. While its occurrence cannot be prevented since its cause is unknown, timely diagnosis and treatment are necessary to avoid complications such as intestinal obstruction. Your child may also present symptoms such as stool that looks like red currant jelly, vomiting, fever, and an abdominal lump. If your child shows any signs of intussusception, don’t offer them OTC drugs or food. Instead, seek immediate medical attention and follow the treatment recommendations.