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Intussusception: A Common Cause of Abdominal Emergency in Children

Tummy aches, or abdominal pains, are common in early childhood. Many times, when your little one has a stomachache, you can chalk it up to a stomach bug, gas or constipation—even nerves. Other times, however, stomach pains – especially painful ones that come on suddenly – can be more worrisome.

While sudden, painful stomach pains could be related to conditions like appendicitis or an infection, there’s another potential cause you may have never heard of that is common in infants and young children: intussusception.

What is intussusception?

If you’ve never heard of this medical condition, you’re not alone. Many people have never heard of intussusception, but it is the most common cause of abdominal emergencies in early childhood, particularly children less than two years old.

“Intussusception is a form of intestinal obstruction or blockage where a loop of the bowel (intestine) telescopes, or slides inward, into another portion of the bowel preventing food from passing through the intestine,” said Swati Kolpuru, MD, a pediatric gastroenterologist with Banner Children's. “This is a serious condition as it can cut the blood supply to the bowel causing tissue damage, infection and internal bleeding.”

Read on to learn four important things about intussusception.

1. There is no real cause for most cases

In most cases of intussusception, there is no clear trigger that causes it. However, in some cases, it might follow a cold, flu or viral infection.

“Evidence suggests that viral infections may play a role, as they may stimulate the lymphatic system, the tissue and organs that are part of the immune system, in the intestinal tract,” Dr. Kolpuru said. “This can make the lymph nodes that line the intestine swell and cause part of the intestine to get pulled into the other.”

In other cases, a polyp, cyst or tumor in the bowel can lead to intussusception.

2. Severe pain may go away and come back

Intussusception is very painful and can often occur suddenly. “Typically, an infant or toddler will have a sudden onset or severe stomach pains and loud, inconsolable crying,” Dr. Kolpuru said. “They may pull their knees toward their chest or stomach and often their face will turn pale.”

However, you may notice the pain comes and goes at first. “These episodes usually occur in 15- to 20-minute intervals in the beginning and become more frequent and severe over time,” Dr. Kolpuru said.

Additional signs to watch out for are:

  • Vomiting: Your child’s throw up may be clear in the beginning and bilious, a yellow-green or dark green fluid, as the bowel obstruction worsens.
  • Bloody, jelly-like stools: Your child’s poop may appear like raspberry or currant jelly due to the mixture of mucus in the blood.
  • Swollen abdomen: You may be able to feel a sausage-shaped mass in their stomach.
  • Change in behavior: Your child may behave normally between episodes but becomes tired and is less alert as intussusception progresses.

3. Intussusception requires immediate medical attention

“Intussusception is a medical emergency that requires urgent attention,” Dr. Kolpuru said. “If left untreated, it can lead to a life-threatening abdominal infection called peritonitis and shock.”

The diagnosis of intussusception is most often made after a physical examination and imaging studies, such as an ultrasound and X-ray, to get a better look inside.

If your child has no evidence of bowel damage, your child may not require surgery. “In many of these cases, intussusception can be pushed back by enema using hydrostatic (fluid) pressure or pneumatic (air) pressure,” Dr. Kolpuru said.

Your provider will place a soft, catheter-like tube in your child’s rectum and use air or a contrast fluid (barium enema), such as barium, to create pressure within the intestine and un-telescope and relieve the obstruction.

If your child’s intestine is torn and they are too sick for an enema, surgical treatment may be required to repair and push the intestine back into place or to remove a part of the bowel. “If part of the bowel has been damaged due to lack of blood flow, that part may need to be removed and the healthy ends reattached,” Dr. Kolpuru said.

Once the intussusception is fixed, your child will gradually recover.

4. Intussusception can sometimes happen again

Most children do well after treatment, however, intussusception could happen again. You’ll need to watch for symptoms. Most children outgrow the risk of intussusception and there should be no further issues.

Final word

Intussusception is a common cause of abdominal emergency in early childhood, particularly children ages two and younger. This occurs when part of the bowel (intestine) slides up inside another part. The bowel can get stuck causing a blockage that can cause severe harm if not treated quickly.

Seek immediate help for your child when you notice the signs. “Most often with early interventions, complications can be avoided,” Dr. Kolpuru said.

To find an urgent care or emergency room near you, visit bannerhealth.com.

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Children's Health Gastroenterology