Intussusception: How to Diagnose

Written by Yao Li Qin
Pediatrics
Updated on January 19, 2025
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Intussusception is one of the most common acute abdominal conditions in infants and toddlers, primarily seen in children under one year old. It refers to the condition where part of the intestine and its mesentery slip into an adjacent intestinal lumen, causing obstruction at the root of the intestine. The diagnosis of intussusception in children is mainly based on clinical symptoms. A previously healthy child may suddenly experience an episode of severe, regular, intermittent colicky pain. The child may appear restless, crying, with knees bent, a reduced amplitude of movement, and a pale complexion, with the abdominal pain easing after 10 to 20 minutes. The child may also vomit and pass bloody stools. Bloody stools are a very important symptom; approximately 85% of cases will pass jelly-like, mucousy bloody stools within 6 to 12 hours of onset, or even if there is no bloody stool visible, rectal examination can reveal its presence. A sausage-shaped mass can be felt in the abdomen. Furthermore, an ultrasound can show a typical image of a concentric circle or target-sign mass. Under ultrasound monitoring, procedures such as air or hydrostatic enema can be performed, which help in the early diagnosis of intussusception.

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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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Written by He Zong Quan
General Surgery
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Can intestinal intussusception have bowel movements?

After the occurrence of intussusception, the patient's symptoms often manifest as those of intestinal obstruction, causing significant abdominal pain, cessation of gas and stool passage through the anus, and a palpable abdominal mass can be felt. Imaging studies can clearly indicate signs of intussusception. Once intussusception occurs, the patient stops passing stool, and symptoms such as vomiting and nausea also occur. Once diagnosed, it is crucial to treat promptly, including air enema reduction or surgical treatment, to promptly address the symptoms of intussusception, prevent the worsening of intestinal obstruction symptoms, and avoid severe complications such as intestinal necrosis, which can endanger the patient's life.

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Written by Hu Qi Feng
Pediatrics
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Can intussusception heal itself?

Once intestinal intussusception occurs, only a small part can be spontaneously reduced. In most cases, urgent reduction treatment is required, including non-surgical and surgical treatments. Non-surgical treatment mainly involves enema therapy. Within 48 hours of the intussusception, if the overall condition is good, the abdomen is not distended, and there are no obvious signs of dehydration or electrolyte imbalance, barium enema treatment can be applied. If the duration of the intussusception exceeds 48 to 72 hours, or if the condition is severe with intestinal necrosis or perforation, surgical treatment is necessary.

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Written by He Zong Quan
General Surgery
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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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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.