Intussusception is the telescoping of one portion of the intestine into another. It is one of the causes of intestinal obstruction during childhood. Half of the cases occur in children younger than I year. It is 3 times more common in males than females. The cause is unknown. The most common site is the small intestine telescoping into the large intestine. Intussusception causes an obstruction to the passage of intestinal contents beyond the problem. In addition, the 2 walls of the intestines press against each other, causing inflammation, edema (swelling), and eventually decreased blood flow. As this process continues, necrosis (death of the intestinal tissue involved) results causing internal bleeding, perforation (hole in the intestines) and peritonitis (infection in the abdomen).This condition must be treated immediately.
Usually a child (most commonly between the ages of 6-18 months) is healthy and thriving and suddenly has abdominal pain. Crying and drawing the knees to the chest may be signs of abdominal pain in an infant. There may be short periods of this abdominal pain between perfectly normal behavior. Vomiting usually occurs and the child may pass one normal brown stool. As the condition worsens, the vomiting increases and the child becomes apathetic (listless). Stools may change to red and jelly-like similar to passing a mucus stool mixed with blood. The child's abdomen will become distended (large) and tender. A sausage shaped mass may be felt in the right part of the abdomen. The child may have a fever, cry and want to stay lying down at this point.
A barium enema will show the obstruction and may correct the problem. The force of the flow of the barium enema may be enough to force the bowel to move back into place similar to pushing an inverted finger out of a glove. An air enema may also be used to correct the problem. Surgery may be needed if the above techniques do not work. Surgery involves an abdominal incision through which the pediatric surgery team pushes the telescoping part of the intestine back into place and may remove any part of the bowel not working correctly. An appendectomy is usually done at the same time.
Your child will probably be in the hospital for a day or so if surgery is not needed and for 2-3 days if surgery is needed because intussusception may reoccur in some cases. If you have any questions about your child's recovery, please ask your nurse or any member of the pediatric surgery team.
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