Can infants with intussusception sleep?

Written by Hu Qi Feng
Pediatrics
Updated on August 31, 2024
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Intussusception presents as abdominal pain, which occurs in sudden, severe, and periodic episodes. The child cries restlessly with a pale face, and the pain lasts several minutes or longer. The pain then subsides, and during this relief, the child falls asleep. The pain reoccurs every ten to twenty minutes. Continuous episodes occur until the intussusception is successfully reduced, after which the child calms down and falls asleep without further crying or vomiting.

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Causes of intussusception in children

The causes of intussusception are divided into primary and secondary types, with 95% being primary, commonly seen in infants and young children. In infants, the mesentery of the ileocecal area is not yet fully fixed and has greater mobility, which is a structural factor prone to intussusception. Secondary cases account for 5%, where intussusception occurs. Some intestines show clear organic changes, such as Meckel's diverticulum, intestinal polyps, intestinal tumors, intestinal duplication anomalies, abdominal purpura, and thickening of the intestinal wall, which can cause intussusception of the intestines. Certain triggers, including dietary changes, viral infections, and diarrhea, can induce intussusception.

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Infant intussusception symptoms

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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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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Can intussusception resolve itself automatically?

Some children with intussusception may resolve spontaneously, but it is important to closely monitor their condition with ultrasound to understand the status of the intussusception. If it does not resolve on its own in a short period, immediate surgical treatment is necessary. If the ultrasound shows successful resolution, or if the child's clinical symptoms such as vomiting and abdominal pain improve and the ultrasound does not reveal any obvious abnormalities, it is considered an automatic recovery.

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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.