Is your little one suddenly crying while clutching their stomach? Learn about Intussusception | Nirogi Lanka

Is your little one suddenly crying out in intense distress while playing? Are they pulling their knees up toward their chest, holding their stomach, and crying inconsolably? Does the crying stop after a while, only to return 15–20 minutes later in the same intense way? Any parent would be rightly frightened by such a sight. These symptoms can be a sign of a condition you may not be familiar with, but one that requires immediate medical attention: Intussusception. Let’s talk about this in detail today on Nirogi Lanka.

In simple terms, what is Intussusception?

Intussusception is a serious and painful condition affecting the intestines. Specifically, it occurs when one part of the bowel slides into the portion immediately ahead of it.

Think of an old-fashioned collapsible telescope. When you extend it, one section slides out from another, and when you fold it, the sections slide inside each other. That is essentially what happens to the intestines during this condition. However, unlike a telescope, your intestines must always remain extended to function properly.

What are the causes and risk factors?

Intussusception is the most common abdominal emergency in children under 2 years of age. While it can occur in older children and adolescents, it is very rare in adults. In adults, if it does occur, it is often due to an underlying condition such as a growth or tumor in the bowel.

In young children, several factors can increase the risk of this condition:

Causes in Adults

If this occurs in an adult, it is often due to one of the following:

• A polyp or tumor in the bowel.
• Adhesions or scar tissue resulting from previous surgery.
• Inflammation of the bowel, such as from Crohn’s disease.
• Weight-loss surgeries like gastric bypass.

What are the exact symptoms?

In an infant who cannot yet speak, they may signal their pain by suddenly crying out and drawing their knees up toward their chest.

Initially, these episodes of pain are brief, occurring every 15–20 minutes. As time passes, the episodes become more frequent and last longer.

However, every child is different. Some may not show obvious pain, so please be vigilant for the following signs:

In adults, this can start as vague abdominal discomfort. If you experience nausea, vomiting, and recurring abdominal pain that intensifies with each episode, you should take it seriously.

When should you see a doctor?

When blood flow to a portion of the intestine is blocked, the tissue in that area begins to die. This can lead to a perforation, allowing an infection to spread into the abdominal cavity. This condition, known as Peritonitis, is extremely dangerous and life-threatening.

If left untreated, your child may go into shock. Key signs of shock include:

• Unusual irritability or restlessness.
• Abnormal heart rate (either very slow or very fast).
• Abnormal breathing (either very shallow or rapid).
• Skin appearing cold, clammy, pale, or grayish.
• A feeling of extreme lethargy or loss of energy.
• Loss of consciousness.

What should you do before seeing the doctor?

Because this is an emergency, hospital staff will act very quickly. Do not panic. Most importantly, do not give your child any food, water, or over-the-counter painkillers until you reach the hospital.

If you have a moment, prepare the answers to questions the doctor might ask to help them provide faster care:

• When did the abdominal pain or symptoms first start?
• Was the pain constant, or did it come and go?
• Has there been nausea, vomiting, or diarrhea?
• Have you noticed blood in the stool?
• Have you noticed any swelling or a lump in the abdomen?

How is it diagnosed?

Your doctor will review your child’s symptoms and medical history, followed by a physical examination. You should expect the medical team to place an IV line to manage hydration and potentially insert a nasogastric tube to relieve pressure in the intestines.

They may also order diagnostic imaging to inspect the abdomen:

• Abdominal X-ray: Helps determine if there is a bowel obstruction.
• Ultrasound scan: Uses sound waves to create images of internal organs. This is a crucial test for identifying intussusception.
• Air or contrast enema: A small tube is gently inserted into the rectum to deliver air or a special liquid called Barium into the bowel. This makes obstructions clearly visible on an X-ray. In some cases, the pressure from this procedure can actually push the telescoped bowel back into its normal position, serving as both a diagnostic and curative treatment.

What are the treatment options?

While some minor cases may resolve on their own, most require medical intervention. If an enema is unsuccessful, the next step is surgery. Do not worry about surgery; the medical team will take every precaution to ensure your child feels no pain.

During surgery:

• A pediatric anesthesiologist (a specialist in anesthesia for children) will ensure your child is completely asleep.
• If performed via laparoscopy (keyhole surgery), the surgeon will make tiny incisions to insert a camera and small instruments to correct the bowel.
• Alternatively, a small incision may be made on the right side of the abdomen to manually reposition the bowel.
• If a portion of the bowel has been damaged beyond repair, the doctor will remove the damaged section and reconnect the healthy ends.

What happens after treatment?

Approximately 1 in 10 children may experience a recurrence within 72 hours. Therefore, whether the treatment was an enema or surgery, your child will remain in the hospital for observation for at least one day.

• If treated via enema:
• Your child may pass gas over the next few hours.
• Acetaminophen can be given for fever or discomfort.
• Nothing is given by mouth for the first 12 hours. Afterward, clear liquids are introduced, followed gradually by solid foods.

• If surgery was performed:
• Your child will spend time in a recovery room before being moved to a ward.
• Pain relief will be provided through the IV line.
• Dressings are usually removed within a few days; if a surgical glue like Dermabond was used, it will dissolve on its own.
• Oral feeding will resume once your child can tolerate clear liquids without vomiting.
• Once your child is eating, drinking, and feeling well, they can be discharged.
• Bathing is usually permitted two days after surgery, but keep your child away from strenuous or contact sports until your follow-up appointment (typically in 2–3 weeks).

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