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Definition Return to top
Intussusception is the sliding of one part of the intestine into another.
Causes Return to top
Intussusception is caused by part of the intestine being pulled inward into itself. This can block the passage of food through the intestine. If the blood supply is cut off, the segment of intestine pulled inside can die.
The pressure created by the walls of the intestine pressing together causes:
The intestine can die, and the patient can have significant bleeding. If a hole occurs, infection, shock, and dehydration can take place very rapidly.
The cause of intussusception is not known, although viral infections may be responsible in some cases. Sometimes a lymph node, polyp, or tumor can trigger the problem. The older the child, the more likely such a trigger will be found.
Intussusception can affect both children and adults, although most cases occur in children ages 6 months - 2 years. It affects boys four times as often as girls.
Symptoms Return to top
The first sign of intussusception is usually sudden, loud crying caused by abdominal pain. The pain is colicky and not continuous (intermittent), but it comes back often, increasing in both intensity and duration.
An infant with severe abdominal pain may draw the knees to the chest while crying.
Other symptoms include:
Exams and Tests Return to top
Your doctor will perform a thorough examination, which may reveal a mass in the abdomen. There may also be signs of dehydration or shock.
Tests may include:
Treatment Return to top
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 obstruction can be treated with an air or contrast enema performed by a skilled radiologist. There is a risk of bowel tearing (perforation) with this procedure, and it is not used if the bowel has already developed a hole.
If these treatments are unsuccessful, the child will need surgery. The bowel tissue can usually be saved, but any dead tissue will be removed.
Intravenous feeding and fluids will be continued until the child has a normal bowel movement.
Outlook (Prognosis) Return to top
The outcome is good with early treatment. There is a risk the condition will come back.
Possible Complications Return to top
A hole (perforation) is a serious complication due to risk of infection. If not treated, intussusception is almost always fatal for infants and young children.
When to Contact a Medical Professional Return to top
Intussusception is an EMERGENCY. Call your health care provider immediately, then call 911 or go immediately to the emergency room.
References Return to top
Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Kliegman: Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007.Update Date: 4/20/2008 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.