How to treat intussusception in infants

Written by Hu Qi Feng
Pediatrics
Updated on September 13, 2024
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The treatment of intussusception mainly includes non-surgical and surgical methods. The non-surgical method involves enema treatment. Within 48 hours of the onset of intussusception, if the overall condition is good, there is no abdominal distension, no apparent dehydration, and no electrolyte disorders, ultrasound-guided hydrostatic enema, air enema, or barium enema can be performed. If the intussusception lasts more than 48 to 72 hours, or if the duration is shorter but the condition is severe, with intestinal necrosis or perforation, surgical treatment is required.

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Written by Hu Qi Feng
Pediatrics
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Does infant intussusception require surgery?

Intussusception lasting between forty-eight and seventy-two hours, or if the duration is shorter but the condition is severe, including cases with intestinal necrosis or perforation, as well as those involving small intestine type intussusception, all require surgical treatment. Depending on the overall condition of the child and the pathological changes in the intussuscepted bowel, options include reduction of intussusception, intestinal resection and anastomosis, or enterostomy, etc.

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Written by Hu Qi Feng
Pediatrics
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How to treat intussusception in infants

The treatment of intussusception mainly includes non-surgical and surgical methods. The non-surgical method involves enema treatment. Within 48 hours of the onset of intussusception, if the overall condition is good, there is no abdominal distension, no apparent dehydration, and no electrolyte disorders, ultrasound-guided hydrostatic enema, air enema, or barium enema can be performed. If the intussusception lasts more than 48 to 72 hours, or if the duration is shorter but the condition is severe, with intestinal necrosis or perforation, surgical treatment is required.

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Written by Hu Qi Feng
Pediatrics
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Can intussusception resolve itself automatically?

Some children with intussusception may resolve spontaneously, but it is important to closely monitor their condition with ultrasound to understand the status of the intussusception. If it does not resolve on its own in a short period, immediate surgical treatment is necessary. If the ultrasound shows successful resolution, or if the child's clinical symptoms such as vomiting and abdominal pain improve and the ultrasound does not reveal any obvious abnormalities, it is considered an automatic recovery.

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Infant intussusception typical symptoms

The typical clinical manifestations of intussusception are as follows: Firstly, abdominal pain, which occurs in paroxysmal, regular episodes, characterized by sudden onset of severe colicky pain. The child appears restless and cries, with knees drawn to the abdomen, pale complexion, and relief coming after several minutes or longer; the pain reoccurs every ten to twenty minutes. Secondly, vomiting is an early symptom, initially reflexive containing milk curds or food residues, later possibly containing bile, and in the late stage, fecal-like liquid may be vomited. Thirdly, bloody stools are a significant symptom, appearing within the first few hours; initially, stools may appear normal, later becoming scanty or absent. In about 85% of cases, a jam-like mucousy bloody stool is passed within six to twelve hours of onset, or bloody stools are found upon rectal examination. Fourthly, abdominal mass is often found in the right upper quadrant just below the ribs, where a slight movable intussusception mass can be palpated, resembling a sausage.

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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.