Is another intestine inside another intestine? All about Intussusception, which is common in young children

Imagine your little baby playing nicely, then suddenly curls up in a ball, pulls his knees to his stomach, and starts crying loudly. No matter how much you try to soothe him, the crying won't stop. But after about 15-20 minutes, the crying stops and he starts playing again, as if nothing happened. You might think it's just a stomach ache. But this could be a much more serious condition called Intussusception , which requires immediate medical attention. It's important for all parents to be aware of this, as it is a medical emergency.

Simply put, what is Intussusception?

Although the name may sound a bit strange, what happens is very simple. Intussusception is when one part of our intestines, like a telescope, swallows another part of it. It's like a sock being rolled up inside itself. This usually happens in the small intestine.

When this happens, the movement of food through the intestine is almost completely stopped, causing a bowel obstruction . In addition, the blood vessels supplying blood to that part of the intestine are compressed, cutting off blood flow. If not treated quickly, this obstruction can cause the intestine to swell, become inflamed, and cause serious complications that can even be life-threatening.

How common is this condition?

Although intussusception can occur at any age, it is most common in children between the ages of 3 months and 3 years . In fact, intussusception is the leading cause of intestinal obstruction in children under the age of 3. It is estimated that about 1 in 2,000 children will develop this condition within their first year of life.

It is very rare in adults. Intussusception accounts for only about 1% of all intestinal obstructions in adults.

How to recognize the symptoms of intussusception?

If you suspect your child has this condition, it is very important to pay close attention to these symptoms.

Symptoms in young children

The symptoms in children are a bit special. The main symptom is a severe, cramping stomachache that goes away after a while. When this pain comes, young children will press their knees to their stomach and cry loudly. This pain can last for about 15-20 minutes. Then the pain suddenly goes away, and the child starts to behave normally again, even playing. This pain-free period can last about 20-30 minutes. Then the severe pain starts again.

As this cycle of pain continues, the baby may become tired, sleepy, and lethargic . They may also develop a fever and, in severe cases, go into shock.

Also pay attention to the following symptoms.

Sometimes, these symptoms can appear a few weeks after a child has had something like a viral fever. So if your child has been sick recently, you should also be suspicious of this.

Symptoms in adults

Intussusception symptoms are a little different in adults. Abdominal pain can come and go like in children, or it can be constant. Vomiting, bloating, and bloody stools are also common in adults. However, because these symptoms are common to many other intestinal diseases, many people try to ignore it. However, intussusception is very dangerous.

Why does this happen? What are the reasons?

Often, it is difficult to find a specific cause for intussusception, especially in young children.

But it has been found that some things can affect this.

• In children: There seems to be a link between viral infections and this condition. Most children develop it during cold weather, when colds and viral gastroenteritis are common. It can also be caused by congenital abnormalities of the intestines, such as a condition called Meckel's diverticulum or small growths in the intestines (polyps).
• In adults: The causes in adults are more obvious. Intussusception is most often caused by something like malignant tumors or benign growths in the colon. Rarely, it can also be caused by long-term inflammatory conditions of the colon, such as Crohn's disease.

Dangerous complications that can occur if left untreated

This is something that needs to be said again and again. Intussusception can be life-threatening if not treated quickly.

• Gastrointestinal perforation: When the intestine becomes blocked, food and digestive juices build up behind it, increasing pressure. This pressure can cause the intestine to swell and eventually burst, forming a hole.
• Severe infection (peritonitis): When the intestine is perforated, its contents leak into the abdominal cavity. This can cause a severe infection that spreads throughout the abdominal cavity, causing a life-threatening condition called sepsis.
• Bowel necrosis: When blood flow to a part of the intestine is cut off, the tissue in that part begins to die without receiving oxygen. If this happens, that part of the intestine may have to be surgically removed.

These complications can occur very quickly. That's why it 's important to treat this as an emergency and go to the hospital's Emergency Department (ETU) immediately .

How do doctors diagnose and treat this?

Usually, both diagnosis and treatment of this condition occur simultaneously. When a child is brought to the hospital with these symptoms, the first thing doctors do is an ultrasound scan. This can determine with 100% accuracy whether or not there is intussusception.

The next and most important step is the process called Air Enema or Contrast Enema .

What is this Enema treatment?

This is not a surgical procedure. In this procedure, a small tube is inserted through the child's rectum, and air (Air Enema) or a special liquid such as `(barium)` (Contrast Enema) is passed through it into the intestine. The pressure created by this air or liquid pushes the part of the intestine that has sunk in back out, straightening the intestine. The doctor watches this entire process through an X-ray video.

Surgery

Intussusception in adults usually requires surgery. Also, some children may need surgery. This is due to:

• If the enema treatment is not successful.
• If a complication such as a perforation of the intestine has already occurred.

The surgery can be done either traditionally, through one large incision in the abdomen (open surgery), or through a procedure called laparoscopy, through several small incisions in the abdomen and with the help of a camera. During the surgery, the doctor will try to straighten the part of the intestine that has slipped. If this is not possible, or if the part is damaged, the part is cut out and the two remaining healthy parts are connected together.

During this surgery, a pediatric anesthesiologist will take care of the child so that he or she does not feel any pain. So there is no need to worry about it.

How will the baby feel after treatment?

After the enema treatment, the child may feel bloated for a few hours. Medications such as paracetamol may be given to control pain and fever.

After surgery, your child will need pain medication. They will be given IV fluids for a few days until their intestines heal. They can usually start eating again within one to three days. It may take a few weeks for your child to return to their normal activities.

If this condition is treated quickly, the recovery rate for children is very high. However, there is a 10% - 20% chance that this will happen again. Therefore, before leaving the hospital, ask your doctor carefully about the symptoms to look out for if this condition occurs again.

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