Causes of intussusception in children

Written by Hu Qi Feng
Pediatrics
Updated on September 23, 2024
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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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Written by Hu Qi Feng
Pediatrics
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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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Written by Hu Qi Feng
Pediatrics
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Symptoms of intussusception in infants

The clinical manifestations of intussusception mainly include abdominal pain, vomiting, bloody stools, and an abdominal mass. The abdominal pain is often spasmodic and regular, manifesting as sudden severe colicky pain. The child appears to be crying and restless, with knees drawn up to the abdomen, pale complexion, and the pain lasts for several minutes or longer but lessens after; it recurs every ten to twenty minutes, accompanied by intestinal movements. Vomiting is an early clinical symptom, initially consisting of milk curds or food residue, and later may include bile and fecal-like liquid. Bloody stool is an important symptom, appearing within the first few hours; initially, the stools can be normal, with about 85% of cases excreting jam-like mucoid bloody stools within six to twelve hours of onset. The abdominal mass is often located in the upper right abdomen below the costal margin, where a slight, tender mass can be palpated.

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Written by Yao Li Qin
Pediatrics
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How is intussusception diagnosed?

Intussusception is one of the common acute abdominal conditions in infants and young children. The primary clinical symptoms include abdominal pain, vomiting, and "jam-like" stools, with a mass often palpable in the abdomen. Initially, the overall condition of the child is generally fine, but in the later stages, symptoms such as dehydration, lethargy, coma, and shock can appear. Any healthy infant or young child who suddenly experiences episodic abdominal pain or periodic, regular bouts of crying, accompanied by vomiting, bloody stools, and a sausage-shaped mass in the abdomen, should be highly suspected of having intussusception. Once intussusception is confirmed, timely enema treatment should be administered to the child, and if the opportunity for an enema has passed, surgical treatment should be considered.

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Written by Quan Xiang Mei
Pediatrics
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How to treat intussusception in children?

Intussusception in children is a common surgical condition. The treatment approach depends on the severity of the child's clinical symptoms. If the intestines have not been telescoped for long, and the intestinal mucosa has not suffered ischemic necrosis, and if the clinical symptoms are mild, air enema can be used to relieve the intussusception without the need for surgery. However, if the clinical symptoms are severe and necrosis has been prolonged, meaning the intestinal mucosa has reached a state of ischemia and necrosis that is irreparable, surgical treatment in a surgical setting is definitely required. Whether surgery or air enema is needed should be decided based on the actual color ultrasound results and a comprehensive diagnosis by the clinician.

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Written by Hu Qi Feng
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Infant Intussusception Symptoms and Treatment

Clinical manifestations of intussusception include: firstly, abdominal pain, which is paroxysmal, regular, and characterized by sudden episodes of colicky pain. The child may cry, appear restless, draw knees to the abdomen, have a pale face, and experience pain that lasts for several minutes or longer. The pain subsides, and the child may fall asleep quietly, but the pain typically recurs at intervals of ten to twenty minutes. Secondly, vomiting is an early symptom, initially reflexive and containing curds and food residue, later possibly including bile. Thirdly, bloody stools are an important symptom, with about 85% of cases passing jelly-like mucoid bloody stools within six to twelve hours after onset. Fourthly, an abdominal mass is often located in the upper right abdomen below the costal margin, where a slightly prominent intussusception mass can be felt. In terms of systemic symptoms, the general condition is good in the early stages, with no symptoms of systemic poisoning. As the disease progresses, the condition worsens, and complications such as intestinal necrosis or peritonitis may develop, leading to deterioration of systemic symptoms and possibly resulting in dehydration, high fever, coma, shock, and other toxic symptoms. Treatment methods include both surgical and non-surgical treatments.