INTUSSUSCEPTION

General Information

DEFINITION--An intestinal obstruction in which the bowel telescopes (folds into itself) forming a tube within a tube.

BODY PARTS INVOLVED--Intestine, usually the large intestine.

SEX OR AGE MOST AFFECTED--All ages, but most common in infants and children between 2 months and 6 years. It is more common in boys.

SIGNS & SYMPTOMS

Early stages:

• Cramping abdominal pain. Infants cry out, bring the legs up to the abdomen and become pale and sweaty during an attack.
• Vomiting.

Later stages:

• Rectal bleeding. This may be dark red material that resembles jelly.
• Swollen abdomen.
• Mass in the abdomen that can be felt.

CAUSES--Unknown factors cause a loop of bowel to turn in on itself. This blocks the bowel's blood supply, causing gangrene and peritonitis. The disorder may be caused by a virus infection but that is unproven.

RISK INCREASES WITH

• Family history of intussusception.
• The seasons (for unknown reasons). It is most common in late spring, early summer and midwinter.
• Leukemia, lymphoma, or cystic fibrosis.
• Recent upper respiratory infection.
• Recent operation (1-24 days previously).

HOW TO PREVENT--Observe your child carefully if symptoms develop. Prevent complications by seeking medical treatment during early stages. No other specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood tests.
• X-rays of the abdomen and intestinal tract (barium enema, See Glossary). The radiologist may manipulate the barium, which may clear the obstruction.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to correct the problem by pushing out the telescoped portion of the intestine. Occasionally a segment of the bowel must be cut out.
• Home care during convalescence.

POSSIBLE COMPLICATIONS

• Dehydration and shock.
• Intestinal perforation and peritonitis.
• Postsurgical infection.

PROBABLE OUTCOME--Spontaneous recovery in 24 hours (sometimes). If not, this is curable with early diagnosis and surgery or barium treatment. Without treatment, complications are life-threatening. The disorder sometimes recurs.

How To Treat

GENERAL MEASURES----Observe your child carefully if symptoms develop. Prevent complications by seeking medical treatment during early stages.

MEDICATION--Medicine usually is not necessary for this disorder unless infection develops. Then your doctor may prescribe antibiotics. Don't use home remedies or non-prescription drugs, such as laxatives, for this condition. They may be dangerous.

ACTIVITY--The child should rest in bed until the obstruction is cleared. Activities may then be resumed gradually.

DIET--Don't feed a child with signs of intestinal obstruction. Intravenous fluids are necessary until the obstruction is removed. No special diet is required afterward.

Call Your Doctor If

Your child has signs or symptoms of intestinal obstruction. This condition changes quickly from a curable one to a life-threatening one.