Intussusception In Children

What is intussusception?

Intussusception is a condition where part of the intestine (bowel) folds into itself like a telescope. The telescoping may block the bowel and its blood supply, which can result in damage to the bowel. Intussusception often involves both small and large bowels. It is the most common cause of bowel obstruction (blockage) in children.

What causes intussusception?

The exact cause of most cases of intussusception in children is not known. It may happen after your child has infections of the nose, throat or bowel that are caused by a virus (germ). Sometimes, an overgrowth of tissues in the intestines may become the place where the intussusception starts. These overgrowths may include a Meckel diverticulum, lymphoma, or an intestinal polyp. Diseases, such as Henoch-Schonlein purpura (HSP) and cystic fibrosis, may affect the bowel wall and increase risk of intussusception. Intussusception may also occur after your child has abdominal (belly) surgery.

What are the signs and symptoms of intussusception?

• Abdominal mass: You may feel a sausage-like mass (lump) in your child's abdomen (belly).
  
  
• Abdominal pain: Your child may have cramping pain in the belly that may be felt only at certain times. In between the times of pain, your child may feel well and act normally. The pain may make your child irritable or fussy. He may be crying too much and not be comforted. Your child may have trouble sleeping or eating.
  
  
• Bowel movement problem: Your child may have bloody and mucus-filled stools (bowel movements). The bowel movement (BM) may look like a red jelly.
  
  
• Other signs and symptoms: Your child may also have vomiting (throwing up). The vomiting together with his BM problems may lead to dehydration. Dehydration means that your child does not have enough body fluids and electrolytes (salts).

How is intussusception diagnosed?

Your child may have one or more of the following tests:

• Abdominal ultrasound: An abdominal ultrasound is a test that looks inside of your child’s belly. Sound waves are used to show pictures of your child’s small and large intestines on a TV-like screen. The ultrasound can help caregivers learn if the telescoped bowel is healthy or sick. It may also help them decide how to fix the intussusception.
  
  
• Abdominal x-rays: Abdominal x-rays are pictures of the organs inside your child's abdomen (belly). Caregivers use these pictures to look for problems such as blocked intestines.
  
  
• Air or barium enema: This test is an x-ray of the colon. The colon is also called the large bowel or large intestine. A tube is put into your child’s anus (rear end). Air or barium is pushed through the tube. Barium is a white, chalky liquid that helps the bowel show up better on the x-ray film. During this test, caregivers will look for the area of the bowel that is blocked or other bowel problems.
  
  
• Computerized tomography scan: This is also called a CT or CAT scan. A type of x-ray machine uses a computer to take pictures of your child's belly. It may be used to look at your child's intestines, including the blood vessels. Your child may be given dye for this test, which helps caregivers see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if your child is allergic to shellfish, or has other allergies or medical conditions.
  
  
• Magnetic resonance imaging: This test is called magnetic resonance imaging. During the MRI, pictures are taken of your child's belly. An MRI may be used to look for blocked intestines and blood vessels, or other bowel problems. Your child will need to lie still during his MRI. Never enter the MRI room with an oxygen tank, wrist watch, or any other metal objects. This can cause serious injury.
  
  
• Small bowel follow-through: This test, also called barium follow-through, takes x-ray pictures of the small bowel. Caregivers will ask your child to drink a white liquid that has barium in it. An x-ray machine is then used to take pictures of your child's belly as the barium goes through the small intestine. This test helps caregivers look for the blocked area of the bowel or other bowel problems.

How is intussusception treated?

Treatment of intussusception will depend on your child's age, symptoms, and how long he has the condition. If your child is dehydrated, he may receive intravenous (IV) fluid. This will replace lost fluids, and prevent further problems. Caregivers may put a nasogastric (NG) tube down his nose, and into the stomach. This may help keep air and fluid out of his belly and stop him from vomiting. Sometimes, an intussusception will unfold by itself and no further treatment is needed. More often, your child may need any of the following for treatment:

• Enema: Caregivers may do an enema, using ultrasound or fluoroscopy (type of x-ray which shows movement) to guide them. There are two types of enemas (barium or air) that may be used by caregivers to unfold your child's intussusception. Caregivers will put a long, flexible tube into your child's rectum. The pressure of the barium or air going into the intestines may cause the bowel to unfold. If this treatment works, your child may not need surgery.
  
  
• Laparotomy: This is surgery to open your child's belly. Caregivers may do a laparotomy if an enema does not unfold the intussusception. It may also be done if your child has an infection or perforated (torn) intestine. During surgery, caregivers look closely at organs inside your child's abdomen and correct problems.

Where can I find more information?

Accepting that your child has intussusception may be hard. You, your family, and those close to you may feel scared, sad, or angry. These are normal feelings. Talk to your child's caregivers, your family, or friends about your feelings. Contact the following for more information:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village , IL 60007-1098
  Phone: 1- 847 - 434-4000
  Web Address: http://www.aap.org
  

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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