Intussusception in Children

Introduction

Intussusception is a serious condition in which one segment of the intestine slides into an adjacent segment, much like the parts of a telescope. This telescoping effect can block the passage of food and fluids, cut off blood supply to the affected part of the intestine, and lead to swelling, inflammation, and tissue damage. Intussusception is most common in infants and young children, particularly between 6 months and 3 years of age, and requires prompt medical attention.

Causes

The exact cause of intussusception is often unknown. In many cases, there is no clear trigger. Sometimes, it may be associated with:

  • Viral infections that cause swelling of the lymphatic tissue in the intestinal wall
  • Polyps, tumors, or other growths (rare in children)
  • Congenital abnormalities of the intestine

Most cases in children are considered idiopathic, meaning no specific cause is found.

Symptoms

Symptoms of intussusception can develop suddenly and may include:

  • Sudden, severe, intermittent abdominal pain (the child may draw their knees up to their chest and cry)
  • Vomiting, which may become bilious (green or yellow)
  • Bloody, “currant jelly” stools (a mixture of blood and mucus)
  • Lethargy or unusual sleepiness
  • Abdominal swelling or a sausage-shaped mass that may be felt in the abdomen
  • Refusal to eat

Symptoms may come and go as the intestine telescopes in and out.

Diagnosis

Diagnosis is based on:

  • Medical history and physical examination
  • Abdominal ultrasound (the preferred imaging test, which can show the characteristic “target” or “doughnut” sign)
  • X-rays or contrast enemas may also be used

Prompt diagnosis is crucial to prevent complications.

Treatment Options

Intussusception is a medical emergency. Treatment options include:

  • Non-surgical reduction: In many cases, a contrast enema (air or liquid) can be used to gently push the telescoped segment back into place. This is both diagnostic and therapeutic.
  • Surgery: If the enema is unsuccessful or if there are signs of intestinal damage or perforation, surgery is required to correct the problem and remove any damaged tissue.

After successful treatment, most children recover fully, but there is a small risk of recurrence.

Prevention

There is no known way to prevent intussusception, as most cases occur without a clear cause. Prompt recognition and treatment are key to preventing complications.

When to Seek Medical Care

Seek immediate medical attention if your child experiences:

  • Sudden, severe, or recurring abdominal pain
  • Vomiting, especially if it is green or yellow
  • Bloody or mucus-filled stools
  • Lethargy or unusual drowsiness
  • Abdominal swelling

Takeaway

Intussusception is a potentially life-threatening condition in children that requires urgent medical care. Early diagnosis and treatment are essential for a full recovery and to prevent serious complications.

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