Does infant intussusception require surgery?

Written by Hu Qi Feng
Pediatrics
Updated on February 23, 2025
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Intussusception lasting between forty-eight and seventy-two hours, or if the duration is shorter but the condition is severe, including cases with intestinal necrosis or perforation, as well as those involving small intestine type intussusception, all require surgical treatment. Depending on the overall condition of the child and the pathological changes in the intussuscepted bowel, options include reduction of intussusception, intestinal resection and anastomosis, or enterostomy, etc.

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Written by Hu Qi Feng
Pediatrics
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Does intussusception require a CT scan?

Intussusception is commonly diagnosed through routine abdominal ultrasound examinations, which have a positive rate of over 90%. In the ultrasound, the transverse section of the intussusception can show concentric circles or target ring-shaped mass images, and the longitudinal section may reveal the sleeve sign. Additionally, a barium enema can be employed, along with X-ray imaging. Under X-ray, the lead point of intussusception appears as a mass shadow, and air enema reduction treatment can be performed concurrently. Generally, CT is not used as a routine diagnostic tool.

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Written by Quan Xiang Mei
Pediatrics
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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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Written by Sun Ming
General Surgery
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Can intussusception in the elderly be cured?

Intussusception in the elderly rarely heals on its own, and the likelihood of recovery without treatment is very small. This is because the causes of intestinal issues in the elderly are primarily benign, often due to cirrhosis or other reasons. Furthermore, intussusception may also occur due to tumors, which generally require surgical treatment. It is advised that if diagnosed with intussusception, it is best to undergo surgical treatment at a hospital to prevent recurrence. If it is due to a tumor, there is a risk of it becoming malignant and metastasizing.

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Written by Hu Qi Feng
Pediatrics
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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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How many days will pneumatic reduction for intussusception take to recover?

The indications of successful reduction of intussusception by air enema treatment are as follows: First, after the removal of the tube, a large amount of foul-smelling mucousy bloody stool and yellow feces are expelled. Second, the patient quickly falls asleep, no longer cries, and ceases to vomit. Third, the abdomen is soft and flat, with no palpable mass as before. Fourth, after the enema reduction, 0.5-1 grams of activated charcoal is administered orally; if charcoal residue is expelled within six to eight hours, it indicates a successful reduction. However, even after successful reduction, it is necessary to remain under observation in the hospital for two to three days to monitor for any recurrence of the intussusception.