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Overview

What Is Intussusception?

Intussusception is a condition in which one section of the intestine slides, or telescopes, into the section next to it. This can block the passage of food and stool and reduce blood flow to the affected bowel. Intestinal intussusception is most often seen in babies and young children, although it can also occur in older children and adults. Prompt medical care is important because the condition can worsen quickly.

Emergency Warning Signs

Emergency Warning Signs of Intussusception

SEEK EMERGENCY CARE

Act quickly when symptoms appear

Sudden or repeated episodes of severe abdominal pain, drawing the knees toward the chest, or inconsolable crying can be warning signs. Repeated vomiting, marked sleepiness or weakness, abdominal swelling, blood or mucus in the stool, or a child who appears seriously ill require emergency care. Do not wait for symptoms to become constant before seeking help.

  • Intermittent severe belly pain may cause a child to cry suddenly and then briefly settle.
  • Repeated vomiting can occur as the bowel becomes blocked.
  • Unusual sleepiness or weakness may indicate serious illness or reduced circulation.
  • A swollen or tender abdomen needs urgent medical assessment.
  • Bloody or mucus-filled stool can be a concerning sign of bowel irritation or damage.
  • Signs of dehydration include very few wet diapers or urinations, a dry mouth, no tears, or unusual weakness.

Symptoms

Intussusception Symptoms

  • Intermittent cramping abdominal pain may occur in repeated episodes.
  • Crying or irritability may begin suddenly during painful episodes.
  • Drawing the knees toward the chest can be a child’s response to belly pain.
  • Vomiting may develop as the intestinal blockage worsens.
  • Poor feeding or refusing feeds may be an early sign in a baby.
  • Lethargy can cause a child to appear unusually sleepy, weak, or less responsive.
  • Abdominal swelling may occur as gas and intestinal contents build up.
  • Bloody or mucus-containing stool, sometimes called currant jelly stool, can occur when the bowel lining is irritated.

Symptoms may come and go at first, so a child can appear comfortable between episodes. Infants cannot describe abdominal pain and may show it through sudden crying, curling up, drawing their legs in, or refusing feeds. Any combination of these symptoms, especially repeated pain and vomiting, needs urgent medical assessment.

Causes

Causes of Intussusception

Intussusception happens when one part of the intestine is pulled into the neighboring section, creating a telescoping blockage. In many young children, no single cause is found; it may occur after a viral illness or swelling of lymphoid tissue in the intestine. In older children and adults, a structural abnormality, sometimes called a lead point, is more likely to start the process.

  • Intestinal polyps can act as a lead point around which the bowel telescopes.
  • Tumors may create a structural lead point, particularly in older children or adults.
  • A Meckel diverticulum can provide an abnormal area that draws one bowel segment into another.
  • Inflammatory bowel disease can cause swelling or changes that contribute to intussusception.
  • Prior intestinal surgery can leave anatomical changes that affect bowel movement.
  • Some bleeding disorders can cause bowel wall swelling or bleeding that contributes to the problem.
  • Cystic fibrosis may produce thick intestinal contents and changes in bowel movement that increase risk.

A structural lead point is more likely to be found in older children and adults and may require additional testing or treatment. In a young child, however, intussusception often occurs without an identifiable structural cause.

Risk Factors

Intussusception Risk Factors

  • Being an infant or young child is the most common age-related risk factor.
  • A previous episode of intussusception increases the chance that it may happen again.
  • A congenital intestinal abnormality can provide a structural point where telescoping begins.
  • Intestinal polyps or tumors may serve as lead points.
  • A Meckel diverticulum can increase the likelihood of bowel telescoping.
  • Inflammatory bowel disease may cause swelling and changes in intestinal movement.
  • Cystic fibrosis can affect intestinal contents and movement.
  • Recent abdominal surgery may alter the shape or movement of the intestine.
  • Conditions that affect intestinal movement can make telescoping more likely.

Most risk factors are related to age, anatomy, or medical conditions rather than lifestyle. There is usually no preventable behavior that causes intussusception, and many affected children have no known risk factor. Small bowel intussusception and intussusception involving the colon may also occur without an obvious trigger.

Complications

Complications of Intussusception

  • Bowel obstruction can prevent food, fluid, and stool from passing normally.
  • Reduced blood supply can deprive the affected intestine of oxygen.
  • Tissue death can occur when reduced blood flow lasts too long.
  • Intestinal perforation is a tear or hole that allows bowel contents to escape.
  • Peritonitis is inflammation and infection of the lining inside the abdomen.
  • Severe dehydration can result from vomiting and inability to keep fluids down.
  • Infection or sepsis can develop when damaged bowel or perforation allows bacteria to spread.
  • Recurrence can occur after successful treatment and requires renewed medical assessment.

The risk of these complications increases when treatment is delayed or the bowel is severely damaged. If part of the intestine loses its blood supply or develops tissue death, surgeons may need to remove the affected segment. This is why suspected intussusception is treated as an emergency.

Treatment & Management

Intussusception Treatment and Management

Intussusception treatment takes place urgently in a hospital. Care may include intravenous fluids, pain control, temporary restriction of food and drink, close monitoring, and assessment by pediatric or general surgery teams. Clinicians choose treatment based on the child’s or adult’s stability, the condition of the bowel, and whether a perforation or structural lead point is suspected.

Air or Contrast Enema Reduction

When the patient is stable and there is no suspected perforation, an air or contrast enema is usually the first treatment. Using imaging guidance, clinicians gently apply pressure through the rectum to push the telescoped bowel back into position. The procedure can both confirm the diagnosis and relieve the obstruction.

  • Perforation requires surgery to repair the bowel and clean the abdominal cavity.
  • Peritonitis requires urgent surgery and treatment for infection.
  • Severe bowel damage or tissue death may require removal of the affected intestinal segment.
  • An unsuccessful enema reduction may require surgical reduction.
  • A recurrent intussusception that cannot be safely reduced may require surgery.
  • A structural lead point that needs removal, such as a polyp, tumor, or Meckel diverticulum, may require surgery.

Outlook and Prognosis

Outlook and Prognosis for Intussusception

Most children recover well when intussusception is diagnosed and treated promptly. Delayed treatment increases the chance of bowel damage, surgery, infection, and a longer recovery. Some patients have a recurrence after successful treatment, so caregivers should follow the medical team’s instructions and watch for returning symptoms.

  • Watch for recurrent abdominal pain, crying, vomiting, or unusual sleepiness.
  • Follow the care team’s instructions for gradually returning to normal feeding.
  • Attend follow-up visits if a structural lead point was identified.
  • Seek urgent care immediately if symptoms return after treatment.

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