What department should I go to for infant intussusception?

Written by Hu Qi Feng

Pediatrics

Updated on September 01, 2024

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Intussusception often occurs in infants and young children, mainly presenting with vomiting, abdominal pain, and bloody stools. The first department usually visited is the emergency pediatrics. If intussusception is confirmed, treatment may involve surgery or non-surgical reduction. Therefore, after confirming intussusception, the patient needs to be transferred to pediatric surgery or general surgery for inpatient treatment.

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Written by Hu Qi Feng

Pediatrics

1min 13sec

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Infant intussusception symptoms

Intussusception clinically presents with abdominal pain, which occurs in fits and starts and has a regular pattern. This manifests as sudden spasmodic colic; the child cries and is restless, drawing the knees up to the belly and turning pale. The pain lasts for several minutes or longer, then eases off, allowing the child to fall asleep quietly. These episodes recur every 10 to 20 minutes as intestinal movements provoke further attacks. Vomiting occurs, initially consisting of curdled milk or food residues and later containing bile-stained, feculent fluid. Moreover, blood in stools is an important symptom. Symptomatically, stools may appear normal for a few hours, but within six to twelve hours, 85% of affected children might pass jelly-like mucus blood stools. A palpable lump can be detected in the upper right abdomen, indicative of the point of intussusception. As for general symptoms, the child may appear well early on, but as the condition worsens, intestinal necrosis or peritonitis may occur, leading to severe dehydration, high fever, lethargy, coma, shock, and other signs of systemic toxicity.

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Written by Hu Qi Feng

Pediatrics

28sec

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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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Written by Hu Qi Feng

Pediatrics

51sec

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Causes of intussusception in children

The causes of intussusception are divided into primary and secondary types, with 95% being primary, commonly seen in infants and young children. In infants, the mesentery of the ileocecal area is not yet fully fixed and has greater mobility, which is a structural factor prone to intussusception. Secondary cases account for 5%, where intussusception occurs. Some intestines show clear organic changes, such as Meckel's diverticulum, intestinal polyps, intestinal tumors, intestinal duplication anomalies, abdominal purpura, and thickening of the intestinal wall, which can cause intussusception of the intestines. Certain triggers, including dietary changes, viral infections, and diarrhea, can induce intussusception.

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Written by Hu Qi Feng

Pediatrics

51sec

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Why does intussusception cause bloody stool?

Once intussusception occurs, only a small portion of the small intestine intussusceptions can reset themselves. Due to the continuous spasm of the sheathed intestinal tract, microcirculatory disorders occur in the intussuscepted segment. Initially, venous blood flow is obstructed, leading to tissue congestion and edema, venous varicosity, and mucosal cells secrete a large amount of mucus into the intestinal lumen, which mixes with blood and feces to form a jam-like jelly substance that is expelled. The intestinal wall becomes edematous, and the obstruction of venous return worsens, affecting the arteries, resulting in insufficient blood supply, and leading to systemic toxic symptoms. In severe cases, intestinal perforation and peritonitis can occur.

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Written by Hu Qi Feng

Pediatrics

42sec

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Can intussusception heal itself?

Once intestinal intussusception occurs, only a small part can be spontaneously reduced. In most cases, urgent reduction treatment is required, including non-surgical and surgical treatments. Non-surgical treatment mainly involves enema therapy. Within 48 hours of the intussusception, if the overall condition is good, the abdomen is not distended, and there are no obvious signs of dehydration or electrolyte imbalance, barium enema treatment can be applied. If the duration of the intussusception exceeds 48 to 72 hours, or if the condition is severe with intestinal necrosis or perforation, surgical treatment is necessary.