Intussusception

The most common abdominal emergency in children under two years of age, intussusception occurs when one portion of the bowel slides into the next, much like a zoom photo lens does when it retracts. Intussusception creates an obstruction in the bowel, with the walls of the intestines pressing against one another. Twisting of the bowel can also cause intussusception, which is considered a very serious disorder in young children. Intussusception occurs most often at the cecum, or the place where the small intestine joins the large intestine. Intestinal blockage leads to swelling, inflammation, and decreased blood flow to the intestines involved.

Intussusception affects between one and four infants out of 1,000 and is three to four times more common in boys than in girls. In the U.S. the condition is rarely fatal because of a greater level of access to quality healthcare than in under-developed nations.

Intense abdominal pain is the most frequent symptom of intussusception. However, an infant will often cry indeterminably. The only clue to abdominal pain might be a change in body positioning as well as anguished crying. The intense abdominal pain erupts suddenly, so that it can cause a child to draw his knees up to the chest. The pain is usually intermittent, but recurs and becomes stronger. As the pain subsides, a child with an intussusception may stop crying and seem fine for a little while. An untreated child will become progressively weaker and may develop a fever and appear to go into shock. Symptoms of shock include lethargy, rapid heartbeat, weak pulse, low blood pressure, and rapid breathing.

If treatment of intussusception is delayed, the infants can suffer tissue damage, perforation of the bowel and even death.

Sources: Bill Berkrot, ”Bowel Problem Seen in Infants Given Merck vaccine,” Scientific American, February, 13, 2007; Paul Wolfson, “Intussusception,” KidsHealth on familydoctor.org, January, 2004.

Symptoms of Intussusception

Symptoms of Intussusception include:

• abdominal swelling or distension,
• passing “currant jelly” stools (bowel movements mixed with blood and mucus),
• vomiting,
• vomiting bile, a gold-brown fluid that the liver secretes which has a bitter taste,
• lethargy (seeming unenergetic, listless, sluggish, or drowsy)
• shallow breathing, and
• the child may sometimes make grunting noises.