Diseases & Conditions


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Intussusception


Intussusception is a disorder in which one segment of the intestine slides into another, much like the parts of a telescope. The affected segments obstruct the bowel and block blood flow. The cause of intussusception is unknown. Symptoms include sudden stomach pain and vomiting. An air enema can confirm the diagnosis and also treat the condition. Sometimes surgery is needed.

Intussusception is the most common cause of intestinal blockage among children between the ages of 3 months and 3 years. Boys are affected slightly more than girls. In most cases, the cause is unknown. Intussusception occasionally affects older children, in whom it is often caused by something in the intestine such as a polyp or tumor. Sometimes, the sliding (telescoping) segments return to normal without treatment. If not, the telescoping segments obstruct the intestine and then shut off the blood flow to the affected area. If blood flow is shut off for more than a few hours, the affected intestine may die (develop gangrene). If a segment of the intestine dies, small holes (perforations) can develop, allowing bacteria to enter the abdominal cavity, resulting in a serious infection (peritonitis).

Symptoms

Intussusception usually causes sudden stomach pain and vomiting in a child who is otherwise healthy. The episodes of pain typically last 15 to 20 minutes. Some children become irritable or listless and apathetic between episodes. Without treatment, the pain becomes continuous, and some children pass currant jelly–like stools with blood and mucus or develop a fever. Children who have a perforation appear ill and have pain when their abdomen is touched.

Diagnosis and Treatment

A doctor may suspect intussusception based on the child's symptoms and a physical examination. An ultrasound can confirm the diagnosis. If an ultrasound confirms intussusception, an air enema is performed. With an air enema, the doctor puts air into the child's rectum through a small tube and then takes x-rays. The pressure of the air usually pushes the telescoped portion of the intestine back into place. The x-rays show whether the procedure was successful. When this procedure is successful, the child can be sent home after an overnight hospital stay. Parents are advised to watch for further symptoms because intussusception can recur in the next 1 to 2 days. Without surgery, intussusception recurs in about 5 to 10% of children.

Surgery is needed if the child has signs of intestinal perforation, if the air enema is not successful in correcting the intussusception, or if the child has recurrences of the condition. In the case of a recurrence, surgery is performed not only to correct the condition but also to look for a polyp, tumor, or other abnormality that could explain why the intussusception recurred.

What Is Intussusception?

One part of the intestine slides into another, much like the parts of a collapsible telescope. As a result, the intestine is blocked.

Last full review/revision December 2007 by William J. Cochran, MD

Source: The Merck Manual Home Edition