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Intussusception - children
Abdominal pain in children - intussusception
Intussusception is the sliding of one part of the intestine into another.
This article focuses on intussusception in children.
Causes
Intussusception is caused by part of the intestine being pulled inward into itself.
The pressure created by the walls of the intestine pressing together causes:
- Decreased blood flow
- Irritation
- Swelling
Intussusception can block the passage of food through the intestine. If the blood supply is cut off, the segment of intestine pulled inside can die. Heavy bleeding may also occur. If a hole develops, infection, shock , and dehydration can take place very rapidly.
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs...
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how muc...
The cause of intussusception is not known. Conditions that may lead to the problem include:
- Viral infection
- Englarged lymph node in the intestine
- Polyp or tumor
The reason for the problem is more likely to be found in older children.
Intussusception can affect both children and adults. However, most cases occur in children ages 6 months to 2 years. It affects boys four times as often as girls.
Symptoms
The first sign of intussusception is very often sudden, loud crying caused by abdominal pain . The pain is colicky and not continuous (intermittent), but it comes back often. The pain will get stronger and last longer each time it returns.
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
An infant with severe abdominal pain may draw the knees to the chest while crying.
Other symptoms include:
- Bloody, mucus-like bowel movement, sometimes called a "currant jelly" stool
- Fever
-
Shock (
pale
color,
lethargy
, sweating)
Pale
Paleness is an abnormal loss of color from normal skin or mucous membranes.
ImageRead Article Now Book Mark ArticleLethargy
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Stool mixed with blood and mucus
- Vomiting
Exams and Tests
Your doctor will perform a thorough exam, which may reveal a mass in the abdomen . There may also be signs of dehydration or shock.
Mass in the abdomen
An abdominal mass is swelling in one part of the belly area (abdomen).
Tests may include:
- Abdominal ultrasound
-
Abdominal x-ray
Abdominal x-ray
An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the spleen, stomach, and intestines. When the ...
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Air or contrast
enema
Enema
Barium enema is a special x-ray of the large intestine, which includes the colon and rectum.
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Treatment
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 blockage can be treated with an air or contrast enema. This is done by a radiologist skilled with the procedure. There is a risk of bowel tearing (perforation) with this procedure.
Bowel blockage
Intestinal obstruction is a partial or complete blockage of the bowel. The contents of the intestine cannot pass through it.
The child will need surgery if these treatments do not work. The bowel tissue can very often be saved. Dead tissue will be removed.
Antibiotics may be needed to treat any infection.
Intravenous feeding and fluids will be continued until the child has a normal bowel movement.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
Outlook (Prognosis)
The outcome is good with early treatment. There is a risk this problem will come back.
When a hole or tear in the bowel occurs, it must be treated right away. If not treated, intussusception is almost always fatal for infants and young children.
When to Contact a Medical Professional
Intussusception is an emergency. Call your doctor right away, then call 911 or go to the emergency room right away.
References
Hostetler MA. Gastrointestinal disorders. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 172.
Kliegman RM, Stanton BF, St Geme JW, Schor NF. Ileus, adhesions, intussusception, and closed-loop obstructions. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 33.
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Colonoscopy - illustration
There are 4 basic tests for colon cancer: a stool test (to check for blood), sigmoidoscopy (inspection of the lower colon, colonoscopy (inspection of the entire colon), and double contrast barium enema. All 4 are effective in catching cancers in the early stages, when treatment is most beneficial.
Colonoscopy
illustration
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Intussusception - X-ray - illustration
This abdominal x-ray shows an intestinal condition in which a loop of bowel has slipped into another section of bowel (intussusception), causing swelling, reduced blood flow, obstruction, and tissue damage. Intussusception requires emergency treatment (barium enema or surgery) to prevent intestinal tissue death (necrosis), intestinal perforation, peritonitis, and death.
Intussusception - X-ray
illustration
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Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
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Colonoscopy - illustration
There are 4 basic tests for colon cancer: a stool test (to check for blood), sigmoidoscopy (inspection of the lower colon, colonoscopy (inspection of the entire colon), and double contrast barium enema. All 4 are effective in catching cancers in the early stages, when treatment is most beneficial.
Colonoscopy
illustration
-
Intussusception - X-ray - illustration
This abdominal x-ray shows an intestinal condition in which a loop of bowel has slipped into another section of bowel (intussusception), causing swelling, reduced blood flow, obstruction, and tissue damage. Intussusception requires emergency treatment (barium enema or surgery) to prevent intestinal tissue death (necrosis), intestinal perforation, peritonitis, and death.
Intussusception - X-ray
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
Review Date: 2/15/2016
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
