What are the other Names for this Condition? (Also known as/Synonyms)

• Bowel Obstruction in Children (due to Intussusception)
• Intestinal Obstruction in Children (due to Intussusception)

What is Intussusception in Children? (Definition/Background Information)

• Intussusception is an abdominal condition in which part of a child’s bowel slides into an adjacent part of the bowel and overlapping occurs. The bowels “telescope” on top of each other and this causes the bowel to become blocked or obstructed
• There is no specific cause of Intussusception in Children in a majority of cases, but pre-existing conditions or illnesses can lead to a blockage
• Intussusception in Children is the most common abdominal abnormality for children that are younger than two years old. 95% of intussusception cases occur in children
• A blockage in the bowels leads to swelling, bleeding, and eventually food cannot be passed through the intestine. The most common symptom of Intussusception in Children is abdominal pain
• Intussusception in Children is commonly treated with either air or barium enemas, which is an injection of air or barium into the lower bowels. If left untreated, intussusception can lead to infection, shock, and even death

Who gets Intussusception in Children? (Age and Sex Distribution)

• Intussusception in Children can occur in any age children. However, it is the most common abdominal defect in children under 2 years old
• Intussusception is most often seen in babies that are 5 to 9 months old 
• Approximately 1-4 out of 1,000 babies may have this abdominal condition
• Male children are 4 times more likely to get intussusception than females
• All racial and ethnic groups are at risk for this condition

What are the Risk Factors for Intussusception in Children? (Predisposing Factors)

There are a few risk factors for Intussusception in Children and these include:

• Very young children: The condition is the most common form of bowel obstruction for children under 3 years of age
• Boys have a greater chance of intussusception than girls
• If the intestines do not form properly at birth, intussusception can occur due to improper formation and rotation of the intestines
• If there is a family history of the condition, the child may be at a higher risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Intussusception in Children? (Etiology)

There is no definite cause for Intussusception in Children. In many cases, healthcare providers are unsure of the cause.

• Sometimes, intussusception can follow a case of stomach flu (a type of gastroenteritis)
• Gastrointestinal infections can lead to swelling of the lymph tissue in the intestine and the intestine might be ‘pulled’ into itself
• For older children, intussusception is more often associated with conditions such as tumors, enlarged lymph nodes, and intestine abnormality

What are the Signs and Symptoms of I Intussusception in Children?

The signs and symptoms of Intussusception in Children mostly involve the presence of abdominal pain. In some cases, children may experience severe abdominal pain.

• A child may put his/her knees up toward the chest while feeling pain
• Loud crying occurs with the onset of pain; the pain may not be continuous, but can be recurrent
• In some children, the pain may be continuous resulting in continuous crying
• Other symptoms of the condition may include:
  • Swelling of the abdomen
  • Fever
  • Sweating
  • Vomiting; vomiting of bile
  • Drowsiness
  • The child makes various noises due to the pain
  • Bowel movements that include blood and mucus in stools
  • Shock

How is Intussusception in Children Diagnosed?

A visit to a healthcare provider is necessary to diagnose Intussusception in Children.

• First, the child’s overall health is examined and family history, medications, and allergies are taken into account
• A healthcare provider will generally examine the abdomen looking for signs and symptoms of intussusception. If intussusception is suspected, the child will most likely be sent to the emergency room for further investigation
• An ultrasound or an X-ray of the abdomen can be used to find an intestinal blockage and diagnose the condition in the child

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Intussusception in Children?

Intussusception in Children can potentially lead to serious complications, if it is left untreated. The complications may include:

• If intussusception continues over time, the child can become very weak
• High temperatures can cause the child to go into a shock
• A hole  can develop in the intestines (intestinal perforation) and lead to infection, dehydration, and shock
• Even when intussusception is treated in a healthcare setting, there is about a 10% chance that it can recur within a few days
• During the enema procedure, there is a risk of bowel tearing that may result in bowel bleeding
• There are times when an enema treatment may not be successful. In such cases, a surgery may need to be performed following the enema procedure

When left untreated, intussusception can lead to irreversible tissue damage, bowel tearing, infection, and even death.

How is Intussusception in Children Treated?

The most common treatment for Intussusception in Children is via enemas, which are injections into the bowels.

• Before any treatments are given, the child has to be stabilized, and towards this:
  • A nasogastric tube is installed in the stomach through the nose
  • An intravenous line is put in the arm to prevent dehydration through fluids
• An air enema is likely to be used to treat the bowel blockage
  • With an air enema, air is passed through a small tube inserted into the rectum
  • Air fills the intestines and outlines the bowels
  • The air pressure is able to help the bowel unfold and correct the blockage
• Barium enemas can also be used to treat Intussusception
  • Barium enemas work in the same way as air enemas and the liquid can be used in the place of air
• While enemas are generally used, surgery may be necessary if enemas are unsuccessful or the child is very ill
• Surgery can be performed to fix the blockage or remove the affected part of the bowel

After treatment of intussusception, the child should remain in the hospital and get intravenous fluids, until normal eating patterns and bowel movements return. In order to prevent infection following treatment, antibiotics may be prescribed.

How can Intussusception in Children be Prevented?

• Currently, there are no definitive measures to prevent Intussusception in Children
• The most important factor to be considered is a quick diagnosis and early treatment of the condition

What is the Prognosis of Intussusception in Children? (Outcomes/Resolutions)

• When Intussusception in Children is treated early enough, the condition can be completely cured. The prognosis in such cases is good
• However, there is always a risk of recurrence or other complications developing from a late treatment of the condition

Additional and Relevant Useful Information for Intussusception in Children:

There is a 5-10% chance that intussusception can recur in children. Hence, any symptoms or abnormalities should be reported to a healthcare provider immediately should they arise.