What is Intussusception?
• Intussusception is a common cause of intestinal obstruction warranting an emergency medical intervention in children aged 3months to 6years with a majority of the cases happening within 24 months of age
• In this condition a segment of the intestine telescopes into the adjoining segment thereby causing an obstruction and also compression of the tissue and blood vessels of the affected segment resulting in swelling, ischemia (blood supply and nutrition cut off) and perforation
• If left untreated this condition can prove to be fatal

Causes
• There is no known cause for intussusception
• However a viral infection (upper respiratory tract infection, ear infection, adenovirus infection), gastrointestinal infection or a food allergy can cause some swelling in the lymphoid tissue patches (Peyer patches) which can act as a lead point for an intussusception to occur
• In older kids polyps, Meckel diverticulum, lymphoma etc. can act as lead points

Symptoms
• Sudden onset of severe ,cramping, intermittent abdominal pain
• During episode of pain the child will cry inconsolably with the knees drawn up towards the abdomen
• Between attacks the child is pain free and sleeps
• Lethargy and refusal to feed may sometimes be the only presenting feature
• Vomiting
• Fever
• Stool may initially be streaked with blood to frank “currant jelly” mucus stools
• Children may appear toxic and in state of shock if not diagnosed early

Diagnosis
• Since all children don’t present with the typical symptoms your doctor will need a high index of suspicion to investigate for intussusception
• On physical exam a distended abdomen with decreased bowel sounds can be present
• A sausage shaped mass may be palpable in the abdomen
• Your doctor may then ask for a
– stool test for occult blood
– X-ray may indicate obstruction
– Abdominal ultrasound is highly sensitive and radiation free hence is increasingly used

Treatment
• Any child with the suspicion of intussusception should be sent to the hospital for emergency investigation and treatment
• Child will need intravenous fluids to stay hydrated and to correct any electrolyte imbalance
• Barium enema is the diagnostic study of choice which is also therapeutic as it provides non-surgical reduction of the intussusception
• If the barium enema reduction is unsuccessful then it is reduced surgically

Team Ovum Hospitals