Symptoms of intussusception in infants

Written by Hu Qi Feng
Pediatrics
Updated on September 22, 2024
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The clinical manifestations of intussusception mainly include abdominal pain, vomiting, bloody stools, and an abdominal mass. The abdominal pain is often spasmodic and regular, manifesting as sudden severe colicky pain. The child appears to be crying and restless, with knees drawn up to the abdomen, pale complexion, and the pain lasts for several minutes or longer but lessens after; it recurs every ten to twenty minutes, accompanied by intestinal movements. Vomiting is an early clinical symptom, initially consisting of milk curds or food residue, and later may include bile and fecal-like liquid. Bloody stool is an important symptom, appearing within the first few hours; initially, the stools can be normal, with about 85% of cases excreting jam-like mucoid bloody stools within six to twelve hours of onset. The abdominal mass is often located in the upper right abdomen below the costal margin, where a slight, tender mass can be palpated.

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Written by Hu Qi Feng
Pediatrics
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How is intussusception in infants caused?

Intussusception is divided into primary and secondary types, with 95% being primary, commonly seen in infants. This is due to the fact that the mesentery at the ileocecal region in infants is not fully fixed and has greater mobility, which are structural factors that facilitate intussusception. For the 5% of secondary cases, these are more common in older children, whose intestines often have clear organic causes for intussusception. These causes include the inversion of a Meckel's diverticulum into the ileal lumen serving as a lead point; intestinal polyps, intestinal tumors, intestinal duplications, and abdominal purpura can cause thickening and swelling of the bowel wall leading to intussusception. Additionally, certain facilitating factors can disrupt the rhythm of intestinal peristalsis, thereby inducing intussusception. Changes in diet, viral infections, and diarrhea are among the factors that can trigger intussusception.

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Written by Hu Qi Feng
Pediatrics
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Typical symptoms of intussusception in children

The typical symptoms of intussusception include abdominal pain, which initially presents as sudden, severe, crampy pain. The affected child may cry, appear restless, draw their knees up to their stomach, and have a pale complexion. The pain may last several minutes or longer and then relieve, with repetitions every ten to twenty minutes. The second symptom is vomiting, which is an early symptom that initially may include curdled milk and food residues, and later may contain bile or fecal matter. The third symptom is bloody stools, where approximately 85% of affected children may pass jelly-like mucus and blood within six to twelve hours of onset. An abdominal mass is often found in the upper right abdomen, and a sausage-shaped mass that is slightly movable upon touch can be felt beneath the ribs. Regarding the overall condition of the child, they may be able to attend school in the early stages without showing signs of toxicity. As the condition progresses, complications such as bowel necrosis or peritonitis can develop, leading to worsening systemic symptoms, including severe dehydration, high fever, drowsiness, coma, or shock.

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Written by Hu Qi Feng
Pediatrics
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Caused by infantile intussusception

Intussusception is divided into primary and secondary types, with 95% being primary cases, most commonly seen in infants and young children. This is due to the fact that the mesentery of the ileocecal part in infants and young children is not yet fully fixed and has a greater degree of mobility, which are structural factors that facilitate the occurrence of intussusception. The remaining 5% are secondary cases generally occurring in older children, where the affected intestines often have a clear organic cause, such as a Meckel's diverticulum turning into the ileal lumen, serving as the starting point for intussusception. Other causes like intestinal polyps, tumors, duplications, or abdominal purpura can cause the intestinal wall to swell and thicken, which can also trigger intussusception.

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Written by Bai Yan Hui
Pediatrics
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Intussusception should visit which department?

Intussusception generally falls under pediatric surgery, but many children arrive at the hospital without a clear self-diagnosis of intussusception; they often come due to abdominal pain. They can visit either the internal medicine department or the surgical department. At this point, the attending physician will conduct a thorough medical history inquiry, such as a standing abdominal radiograph, abdominal ultrasonography, and physical examination, to aid in diagnosis. If a diagnosis confirms the need for surgical intervention, whether it involves air enema or surgery, it is definitely within the scope of the surgical department.

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Written by Quan Xiang Mei
Pediatrics
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Does intussusception cause diarrhea?

Intussusception is a common surgical condition in infants and young children, characterized primarily by symptoms such as abdominal pain, crying, abdominal distension, the passage of jelly-like stools, and vomiting. Some children may also experience diarrhea and frequent passage of jelly-like stools, where the symptoms of intussusception may not be particularly noticeable, leading parents to possibly overlook them. Therefore, if a child has diarrhea accompanied by jelly-like stools, it is crucial to take the child to the hospital for a consultation and an ultrasound to confirm whether it is caused by intussusception. If left untreated for a long time, it can lead to ischemic necrosis of the intestinal mucosa, necessitating surgical treatment.