Diseases & Conditions

Intussusception

Intussusception is a rare but serious disorder in which part of the intestine — either the small intestine or colon — slides into another part of the intestine. This "telescoping" often blocks the intestine, preventing food or fluid from passing through. Intussusception also cuts off the blood supply to the part of the intestine that's affected.

Intussusception is the most common cause of intestinal obstruction among children. Intussusception is rare in adults. Most cases of adult intussusception are the result of an underlying medical condition. In contrast, most cases in children have no demonstrable cause.

With prompt attention, intussusception can often be successfully treated without lasting problems.

Children
Signs and symptoms of intussusception in children include:

• Severe abdominal pain that comes and goes (intermittent pain)
• Stool mixed with blood and mucus (sometimes referred to as "currant jelly" stool because of its appearance)
• A lump in the abdomen
• Swollen (distended) abdomen
• Vomiting
• Diarrhea
• Fever
• Dehydration
• Lethargy
• Shallow breathing

The first sign of intussusception in infants is usually sudden, loud crying caused by abdominal pain. Infants who have abdominal pain may pull their knees to their chests when they cry. The pain of intussusception comes and goes, usually every 15 to 20 minutes at first. These painful episodes last longer and happen more frequently as time passes.

Adults
Although rare, intussusception can happen in adults. Signs and symptoms of intussusception in adults may last a long time (chronic symptoms), or they may come and go (intermittent symptoms). They may include:

• Changes in bowel movement frequency
• The urge to have a bowel movement immediately (urgency)
• Rectal bleeding
• Crampy abdominal pain
• Pain in one area of the abdomen
• Swollen (distended) abdomen
• Nausea
• Vomiting

When to see a doctor
Intussusception requires emergency medical care. If you or your child develops the signs or symptoms listed above, seek medical help right away.

In infants, remember that signs of abdominal pain may include recurrent bouts of pulling the knees to the chest and crying.

Intussusception can cut off the blood supply to the affected portion of the intestine. If left untreated, lack of blood causes tissue of the intestinal wall to die. Tissue death can result in a tear (perforation) in the intestinal wall, which can lead to peritonitis, an infection of the lining of the abdominal cavity.

Peritonitis is a life-threatening condition that requires immediate medical attention. Signs and symptoms of peritonitis include:

• Abdominal pain
• Abdominal swelling
• Fever
• Thirst
• Low urine output

Peritonitis may cause your child to go into shock. Signs and symptoms of shock include:

• Cool, clammy skin that may be pale or gray
• A weak and rapid pulse
• Abnormal breathing that may be either slow and shallow or very rapid
• Dilated pupils in the eyes
• Lackluster eyes that seem to stare

A child who is in shock may be conscious or unconscious. If you suspect your child is in shock, seek emergency medical care right away.

Emergency medical care is required to treat intussusception to avoid severe dehydration and shock, as well as prevent infection that can occur when a portion of intestine dies due to lack of blood.

When your child arrives at the hospital, the doctors will first stabilize his or her medical condition. This includes giving your child fluids through an intravenous (IV) line and putting a tube through the child's nose and into the stomach (nasogastric tube) to allow the intestines to decompress.

Doctors can often use a barium or air enema to correct the telescoping intestine and successfully treat intussusception. If an enema works, no further treatment is necessary.

If the intestine is torn or if an enema is unsuccessful in correcting the problem, surgery is necessary. The surgeon will free the portion of the intestine that is trapped, clear the obstruction and, if necessary, remove any of the intestinal tissue that has died.

In some cases, intussusception may be temporary and improve on its own without treatment. If no underlying medical condition is found that caused the intussusception, no further treatment is necessary.