How to treat intussusception in children?

Written by Hu Qi Feng
Pediatrics
Updated on September 03, 2024
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Intussusception is a life-threatening emergency that requires urgent reduction once diagnosed. Reduction methods include non-surgical and surgical therapies. Within forty-eight hours of intussusception, if the overall condition is good, there is no abdominal distension, and no significant dehydration or electrolyte imbalance, reduction can be attempted under ultrasound guidance using hydrostatic enema, air enema, or barium enema. If the intussusception has lasted beyond forty-eight to seventy-two hours, or if there is severe abdominal distention, intestinal necrosis, or perforation, surgical treatment is necessary.

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Written by Hu Qi Feng
Pediatrics
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Typical symptoms of intussusception in children

The typical symptoms of intussusception include abdominal pain, which initially presents as sudden, severe, crampy pain. The affected child may cry, appear restless, draw their knees up to their stomach, and have a pale complexion. The pain may last several minutes or longer and then relieve, with repetitions every ten to twenty minutes. The second symptom is vomiting, which is an early symptom that initially may include curdled milk and food residues, and later may contain bile or fecal matter. The third symptom is bloody stools, where approximately 85% of affected children may pass jelly-like mucus and blood within six to twelve hours of onset. An abdominal mass is often found in the upper right abdomen, and a sausage-shaped mass that is slightly movable upon touch can be felt beneath the ribs. Regarding the overall condition of the child, they may be able to attend school in the early stages without showing signs of toxicity. As the condition progresses, complications such as bowel necrosis or peritonitis can develop, leading to worsening systemic symptoms, including severe dehydration, high fever, drowsiness, coma, or shock.

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Written by Hu Qi Feng
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What department should I go to for infant intussusception?

Intussusception often occurs in infants and young children, mainly presenting with vomiting, abdominal pain, and bloody stools. The first department usually visited is the emergency pediatrics. If intussusception is confirmed, treatment may involve surgery or non-surgical reduction. Therefore, after confirming intussusception, the patient needs to be transferred to pediatric surgery or general surgery for inpatient treatment.

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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
Pediatrics
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Caused by infantile intussusception

Intussusception is divided into primary and secondary types, with 95% being primary cases, most commonly seen in infants and young children. This is due to the fact that the mesentery of the ileocecal part in infants and young children is not yet fully fixed and has a greater degree of mobility, which are structural factors that facilitate the occurrence of intussusception. The remaining 5% are secondary cases generally occurring in older children, where the affected intestines often have a clear organic cause, such as a Meckel's diverticulum turning into the ileal lumen, serving as the starting point for intussusception. Other causes like intestinal polyps, tumors, duplications, or abdominal purpura can cause the intestinal wall to swell and thicken, which can also trigger intussusception.

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Written by Li Chang Yue
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Can you drink water with intussusception?

Patients with intestinal intussusception should avoid drinking water as much as possible. Once intussusception occurs, it can lead to a complete intestinal obstruction. Drinking water at this time can easily increase the burden on the intestines, causing nausea, vomiting, abdominal distension, and a series of other problems. For patients with intestinal intussusception, an emergency intestinal barium air pressure procedure can be performed to reposition the intestines. If this fails, surgical treatment should be pursued actively. Currently, patients with intussusception can be treated with traditional open surgery to release the intussusception, or using laparoscopic interventions to resolve it. Both types of surgery are very effective in treating intussusception and typically have satisfactory outcomes.