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Intussusception

What is intussusception?

In this condition, a segment of intestine slides into the segment next to it, like a telescope. Then the walls of the intestine press against each other. This blocks the flow of stool (feces). The area hurts and swells. Pressure cuts off blood flow to the intestine, which can damage the tissue. Intussusception (pronounced in-tuss-uss-EPP-shun) needs treatment right away to prevent serious health problems.

Who gets intussusception?

Any child can get this condition, but it's most common in children 6 months to 2 years old. In fact, it's the most common belly (abdominal) emergency in children this age. About 1 to 4 children in 1,000 get intussusception.

What are the symptoms?

Almost all children with this condition have pain in their belly. In most cases, the pain is intense. It often starts suddenly. Children with pain from intussusception may cry and draw their knees up to their chest. The pain may come and go. When the pain is gone, the child may seem fine. The pain tends to get worse each time it returns.

Your child may also have any of these symptoms:

  • Swelling in the belly
  • Blood and mucus in the stool, which may look purple
  • Vomiting
  • Seeming sluggish (lethargy)
  • Weakness
  • Fever

How do you diagnose intussusception?

The doctor will ask about your child's symptoms and carefully examine your child's belly, feeling for swollen, blocked intestine. Your child may also need an X-ray or ultrasound exam so the doctor can see the intestine. They may also need a contrast study called a barium enema. This study can be used to diagnose as well as treat the condition.

What is your experience with intussusception at Children's?

We treat many children every year with this condition. In most cases, they don't need surgery. Children's has the lowest rate of operating on these children of any hospital in Washington because we can usually treat them without surgery. Some children do need an operation, and our surgeons are experienced at performing surgery for those children who do need it.

When you come to Children's, you have a team of people to care for your child before, during and after surgery. Along with your child's surgeon, you are connected with nurses, dietitians, child life specialists, social workers and others. We work together to meet all of your child's health needs and help your family through this experience.

Since 1907, Children's has been treating children only. Our team members are trained in their fields and also in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age. Our expertise in pediatrics truly makes a difference for our patients and families.

How do you treat intussusception?

In most cases, doctors can treat this condition without doing surgery. A few children need an operation.

Enema treatment

Doctors begin by giving your child an enema to gently push the intestine that has telescoped into the neighboring intestine back to its normal position. Doctors call this reducing the intussusception. Our doctors usually try an air enema first. This means they put air into the intestine through a tube in your child's anus.

If this doesn't work, doctors may try a liquid enema. It contains dye that shows up on an X-ray. This is called a contrast enema. It may work even if the air enema did not. Even if the contrast enema doesn't work, it is still useful because it helps doctors see on an X-ray where the blockage is, and it may help reduce the surgery needed.

If enema treatment works, you can expect your child to stay in the hospital overnight. This way we can make sure your child is processing food well and can pass stool.

Surgery

Your child will need surgery right away if an enema doesn't work. If the doctor thinks your child's intestine has been damaged by the intussusception, your child may go into surgery right away instead of having an enema first, though this is not common.

At the time of surgery, your child will have general anesthesia. This means we will give your child medicine to make them sleep without pain during the surgery. Then the surgeon will make a cut, or incision, in your child's abdomen. The surgeon may do this operation laparoscopically (through three or four tiny incisions) or through one larger incision. Your surgeon will discuss with you which option may be best for your child.

Once inside, the surgeon will squeeze the telescoped intestine back into place if possible. Very often surgeons remove the appendix during this operation. If the intestine is severely damaged or cannot be squeezed back into place, the surgeon will cut out the damaged section and sew the loose ends together.

The length of the surgery depends on exactly what your child needs. It takes at least 30 minutes to one hour, sometimes longer. Your child will be in the recovery room for another hour.

After surgery

After surgery, you can expect your child to stay in the hospital at least overnight and possibly up to about a week. We will give your child pain medicine to make them comfortable. It takes some time for the intestine to recover after surgery. How soon your child can eat or drink will depend on the operation that had to be done.

After your child goes home, you'll need to keep the incision clean and dry until it heals. The surgery team will teach you how to care for the incision, explain what kinds of food or medicine to give your child, and tell you if you need to limit your child's activity for a while. Between 1% and 5% of children get intussusception again, so you will need to watch for symptoms.

About two to three weeks after surgery, your child will need to see the surgeon for a follow-up visit. The surgeon will make sure the incision is healing and your child is recovering well.

Resources

Read more about what to expect when your child visits a clinic at Children's, has surgery here or needs to stay in the hospital. You can get practical details about topics like what to do and bring the day of surgery and who will be on your child's care team. You can also take a virtual tour of our surgery rooms and other parts of the hospital.

To learn more about this condition, you may want to visit our resource list.