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
Pediatrics
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Intestinal intussusception described by ultrasound.

The appearance of intussusception under ultrasound shows concentric or target ring-shaped mass images on a transverse section scan, and a sleeve sign on a longitudinal section scan. For an ultrasound-guided hydrostatic reduction, a balloon is inserted through the anus and inflated, connecting a T-tube to a Foley catheter with a side tube connected to a sphygmomanometer to monitor water pressure. Isotonic saline at a temperature of thirty to forty degrees is injected, and the target ring-shaped mass image can be seen retracting to the ileocecal region. The disappearance of the concentric circles or sleeve sign under ultrasound indicates the completion of this therapeutic diagnosis.

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Written by Yan Xin Liang
Pediatrics
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Early symptoms of intussusception in children

Intussusception in children refers to a segment of the intestine telescoping into the adjoining lumen, causing an obstruction to the passage of intestinal contents. Intussusception accounts for 15%-20% of intestinal obstructions and can be primary or secondary. Generally, primary intussusception is more common in infants and young children. Early symptoms may include bloating, abdominal pain, vomiting, possibly accompanied by bloody stools, and a palpable mass in the abdomen. Moreover, intussusception can occur in multiple locations, such as jejunum into jejunum, jejunum into ileum, ileum into ileum, ileum into cecum, ileum into colon, colon into colon, etc. Among these, ileo-cecal intussusception is the most common, while small intestine into small intestine and colon into colon are relatively rare.

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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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Why does intussusception cause bloody stool?

Once intussusception occurs, only a small portion of the small intestine intussusceptions can reset themselves. Due to the continuous spasm of the sheathed intestinal tract, microcirculatory disorders occur in the intussuscepted segment. Initially, venous blood flow is obstructed, leading to tissue congestion and edema, venous varicosity, and mucosal cells secrete a large amount of mucus into the intestinal lumen, which mixes with blood and feces to form a jam-like jelly substance that is expelled. The intestinal wall becomes edematous, and the obstruction of venous return worsens, affecting the arteries, resulting in insufficient blood supply, and leading to systemic toxic symptoms. In severe cases, intestinal perforation and peritonitis can occur.

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Written by Hu Qi Feng
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Is intussusception in children serious?

Intussusception is a life-threatening emergency, and its reduction is an urgent medical treatment that must be performed immediately once diagnosed. Generally, in the early stages of intussusception, the general condition is still good, with normal body temperature and no symptoms of systemic toxicity. As time progresses, the condition worsens, and there may be necrosis of the intestines or peritonitis, with overall health deteriorating. Common severe symptoms include dehydration, high fever, lethargy, coma, and shock from toxicity.