Can intussusception in children cause fever?

Written by Hu Qi Feng
Pediatrics
Updated on September 23, 2024
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In the early stages of intussusception, the child generally remains in good condition, with normal body temperature and no symptoms of systemic poisoning. As the disease progresses and worsens, complications such as intestinal necrosis or peritonitis may develop, leading to deterioration of the overall condition. At this point, severe dehydration, high fever, lethargy, coma, and shock, among other symptoms of poisoning, can occur. Therefore, fever can indeed appear in the later stages of intussusception.

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Written by Yan Xin Liang
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Early symptoms of intussusception in children

Intussusception in children refers to a segment of the intestine telescoping into the adjoining lumen, causing an obstruction to the passage of intestinal contents. Intussusception accounts for 15%-20% of intestinal obstructions and can be primary or secondary. Generally, primary intussusception is more common in infants and young children. Early symptoms may include bloating, abdominal pain, vomiting, possibly accompanied by bloody stools, and a palpable mass in the abdomen. Moreover, intussusception can occur in multiple locations, such as jejunum into jejunum, jejunum into ileum, ileum into ileum, ileum into cecum, ileum into colon, colon into colon, etc. Among these, ileo-cecal intussusception is the most common, while small intestine into small intestine and colon into colon are relatively rare.

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Can intussusception in the elderly be cured?

Intussusception in the elderly rarely heals on its own, and the likelihood of recovery without treatment is very small. This is because the causes of intestinal issues in the elderly are primarily benign, often due to cirrhosis or other reasons. Furthermore, intussusception may also occur due to tumors, which generally require surgical treatment. It is advised that if diagnosed with intussusception, it is best to undergo surgical treatment at a hospital to prevent recurrence. If it is due to a tumor, there is a risk of it becoming malignant and metastasizing.

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Can intussusception pass gas?

Intussusception should be considered when the patient shows symptoms of intestinal obstruction, namely pain, vomiting, distension, and paralysis, along with cessation of gas and stool passing through the anus. In the early stages of intussusception, there may be a small amount of gas and stool passage, but the presence of intussusception should not be overlooked, and imaging studies can be performed for confirmation. If there is a fluid level in the intestinal lumen and clear signs of intestinal obstruction, and if the patient can feel a distinct mass in the abdomen, which on imaging shows concentric ring-like changes, intussusception should be considered. Once diagnosed, timely treatment is essential, thus treatment should not be delayed until there is an absence of stool and gas passage.

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Written by Hu Qi Feng
Pediatrics
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Symptoms of intussusception in infants

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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How to treat intussusception in children?

Intussusception in children is a common surgical condition. The treatment approach depends on the severity of the child's clinical symptoms. If the intestines have not been telescoped for long, and the intestinal mucosa has not suffered ischemic necrosis, and if the clinical symptoms are mild, air enema can be used to relieve the intussusception without the need for surgery. However, if the clinical symptoms are severe and necrosis has been prolonged, meaning the intestinal mucosa has reached a state of ischemia and necrosis that is irreparable, surgical treatment in a surgical setting is definitely required. Whether surgery or air enema is needed should be decided based on the actual color ultrasound results and a comprehensive diagnosis by the clinician.