Infant intussusception symptoms

Written by Hu Qi Feng
Pediatrics
Updated on September 01, 2024
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Intussusception clinically presents with abdominal pain, which occurs in fits and starts and has a regular pattern. This manifests as sudden spasmodic colic; the child cries and is restless, drawing the knees up to the belly and turning pale. The pain lasts for several minutes or longer, then eases off, allowing the child to fall asleep quietly. These episodes recur every 10 to 20 minutes as intestinal movements provoke further attacks. Vomiting occurs, initially consisting of curdled milk or food residues and later containing bile-stained, feculent fluid. Moreover, blood in stools is an important symptom. Symptomatically, stools may appear normal for a few hours, but within six to twelve hours, 85% of affected children might pass jelly-like mucus blood stools. A palpable lump can be detected in the upper right abdomen, indicative of the point of intussusception. As for general symptoms, the child may appear well early on, but as the condition worsens, intestinal necrosis or peritonitis may occur, leading to severe dehydration, high fever, lethargy, coma, shock, and other signs of systemic toxicity.

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Infant intussusception typical symptoms

The typical clinical manifestations of intussusception are as follows: Firstly, abdominal pain, which occurs in paroxysmal, regular episodes, characterized by sudden onset of severe colicky pain. The child appears restless and cries, with knees drawn to the abdomen, pale complexion, and relief coming after several minutes or longer; the pain reoccurs every ten to twenty minutes. Secondly, vomiting is an early symptom, initially reflexive containing milk curds or food residues, later possibly containing bile, and in the late stage, fecal-like liquid may be vomited. Thirdly, bloody stools are a significant symptom, appearing within the first few hours; initially, stools may appear normal, later becoming scanty or absent. In about 85% of cases, a jam-like mucousy bloody stool is passed within six to twelve hours of onset, or bloody stools are found upon rectal examination. Fourthly, abdominal mass is often found in the right upper quadrant just below the ribs, where a slight movable intussusception mass can be palpated, resembling a sausage.

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Written by Quan Xiang Mei
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Does intussusception cause diarrhea?

Intussusception is a common surgical condition in infants and young children, characterized primarily by symptoms such as abdominal pain, crying, abdominal distension, the passage of jelly-like stools, and vomiting. Some children may also experience diarrhea and frequent passage of jelly-like stools, where the symptoms of intussusception may not be particularly noticeable, leading parents to possibly overlook them. Therefore, if a child has diarrhea accompanied by jelly-like stools, it is crucial to take the child to the hospital for a consultation and an ultrasound to confirm whether it is caused by intussusception. If left untreated for a long time, it can lead to ischemic necrosis of the intestinal mucosa, necessitating surgical treatment.

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Can intussusception heal itself?

Once intestinal intussusception occurs, only a small part can be spontaneously reduced. In most cases, urgent reduction treatment is required, including non-surgical and surgical treatments. Non-surgical treatment mainly involves enema therapy. Within 48 hours of the intussusception, if the overall condition is good, the abdomen is not distended, and there are no obvious signs of dehydration or electrolyte imbalance, barium enema treatment can be applied. If the duration of the intussusception exceeds 48 to 72 hours, or if the condition is severe with intestinal necrosis or perforation, surgical treatment is necessary.

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Causes of intussusception in children

The etiology of intussusception is divided into primary and secondary types, with 95% being primary, which is common in infants and young children. In infants, the mesentery of the ileocecal region is not yet fully fixed and has a larger degree of mobility, which is a structural factor conducive to the occurrence of intussusception. Secondary cases account for about 5%, often secondary to Meckel's diverticulum, intestinal polyps, intestinal tumors, intestinal duplications, and abdominal purpura causing swelling and thickening of the intestinal wall, which can lead to intussusception. Certain factors may cause a change in the rhythmic movement of the intestines leading to disorder, thereby inducing intussusception, such as changes in diet, viral infections, and diarrhea.

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Symptoms of recurrent intussusception in children

5-8% of the children may experience recurrent intussusception. Enema reduction has a higher recurrence rate than surgical reduction. The manifestations of recurrence are similar to the initial episode, primarily presenting as abdominal pain, vomiting, bloody stools, or a palpable intussusceptum-like mass in the abdomen. The abdominal pain is mainly intermittent, and can last for several minutes or longer, accompanied by pale complexion. The vomitus may include curds or food residues, possibly containing bile; in later stages, it may resemble fecal matter. Bloody stools may appear as jelly-like mucoid blood.