How is intussusception in infants caused?

Written by Hu Qi Feng
Pediatrics
Updated on January 10, 2025
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Intussusception is divided into primary and secondary types, with 95% being primary, commonly seen in infants. This is due to the fact that the mesentery at the ileocecal region in infants is not fully fixed and has greater mobility, which are structural factors that facilitate intussusception. For the 5% of secondary cases, these are more common in older children, whose intestines often have clear organic causes for intussusception. These causes include the inversion of a Meckel's diverticulum into the ileal lumen serving as a lead point; intestinal polyps, intestinal tumors, intestinal duplications, and abdominal purpura can cause thickening and swelling of the bowel wall leading to intussusception. Additionally, certain facilitating factors can disrupt the rhythm of intestinal peristalsis, thereby inducing intussusception. Changes in diet, viral infections, and diarrhea are among the factors that can trigger intussusception.

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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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How long will diarrhea from intussusception take to get better?

Intussusception causes diarrhea. In such cases, the intussusception itself indicates an intestinal blockage. Patients with the obstruction will experience significant pain, vomiting, bloating, and closure. The anus will stop discharging gas or stool. If diarrhea occurs at this time, it is not caused by the intussusception. If the intussusception cannot be resolved, the diarrhea will improve in the short term. Of course, we must address the main issue of intussusception, and the diarrhea can be temporarily disregarded. We only need to perform air enema reduction and mainly resolve the intestinal obstruction and intussusception through surgical treatment. Diarrhea, because it is treated with IV fluids and some intestinal anti-inflammatory medications, will naturally subside.

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Pediatrics
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Pediatric intussusception clinical manifestations

Intussusception often occurs in infants and young children. The symptoms of intussusception in infants and young children primarily include abdominal pain, crying, and vomiting as the main clinical manifestations. Frequent vomiting, abdominal distension, and abdominal pain are symptoms, with children exhibiting sudden abdominal distension, sudden abdominal pain, and sudden sharp screams. The most typical symptom of intussusception is the excretion of jelly-like stool, which resembles tomato sauce or jelly. These are common clinical presentations of intussusception in children. Some children who are less neurologically sensitive may only show symptoms of lethargy, mild vomiting, diarrhea, and the passing of jelly-like stool.

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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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The earliest symptoms of intussusception in infants

The early symptoms of infantile intussusception mainly include abdominal pain and vomiting. The abdominal pain is typically paroxysmal and severe, manifesting as acute, intermittent colic. The child may cry and be restless, curling up with knees drawn in, and may appear pale. The abdominal pain eases after several minutes or more, but reoccurs every ten to twenty minutes. Vomiting mainly involves reflexive vomiting of curdled milk or food residues. In later stages, bile and fecal-like liquid may be present, indicating intestinal obstruction.