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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Written by Hu Qi Feng
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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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What tests need to be done for intussusception?

Intussusception is a common surgical disease in infants and young children, characterized clinically by crying, abdominal pain, abdominal distention, the passage of jelly-like stools, and vomiting. Auxiliary examinations for this condition primarily involve abdominal ultrasonography, though occasionally an abdominal X-ray can be performed. If a child experiences intussusception, treatment can vary depending on the severity; mild cases might be treated with an air enema. However, if the symptoms of intussusception are severe and prolonged, leading to ischemic necrosis of the intestines, surgical intervention is definitely required. In summary, the examination for intussusception primarily involves abdominal ultrasonography.

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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.

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Can pediatric intussusception be cured?

Once intussusception occurs, only a small portion of the small intestinal intussusception can reduce on its own. Those occurring in the colon or where re-intussusception occurs generally cannot reduce spontaneously and require enema therapy or surgical treatment. Enema therapy refers to cases where the intussusception occurs within forty-eight hours, the overall condition is good, there is no abdominal distension, no obvious dehydration or electrolyte disorders, and air or barium enema can be used. If the condition persists for more than forty-eight hours, the overall condition is poor, with symptoms such as dehydration, lethargy, high fever, shock, significant abdominal distension, signs of peritoneal irritation, multiple occurrences of intussusception, prior organic changes, or situations requiring surgical treatment for small bowel intussusception.

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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.