How is intussusception in infants caused?

Written by Hu Qi Feng
Pediatrics
Updated on January 10, 2025
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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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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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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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Written by Yao Li Qin
Pediatrics
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Intussusception: How to Diagnose

Intussusception is one of the most common acute abdominal conditions in infants and toddlers, primarily seen in children under one year old. It refers to the condition where part of the intestine and its mesentery slip into an adjacent intestinal lumen, causing obstruction at the root of the intestine. The diagnosis of intussusception in children is mainly based on clinical symptoms. A previously healthy child may suddenly experience an episode of severe, regular, intermittent colicky pain. The child may appear restless, crying, with knees bent, a reduced amplitude of movement, and a pale complexion, with the abdominal pain easing after 10 to 20 minutes. The child may also vomit and pass bloody stools. Bloody stools are a very important symptom; approximately 85% of cases will pass jelly-like, mucousy bloody stools within 6 to 12 hours of onset, or even if there is no bloody stool visible, rectal examination can reveal its presence. A sausage-shaped mass can be felt in the abdomen. Furthermore, an ultrasound can show a typical image of a concentric circle or target-sign mass. Under ultrasound monitoring, procedures such as air or hydrostatic enema can be performed, which help in the early diagnosis of intussusception.

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Written by He Zong Quan
General Surgery
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How long will diarrhea from intussusception take to get better?

Intussusception causes diarrhea. In such cases, the intussusception itself indicates an intestinal blockage. Patients with the obstruction will experience significant pain, vomiting, bloating, and closure. The anus will stop discharging gas or stool. If diarrhea occurs at this time, it is not caused by the intussusception. If the intussusception cannot be resolved, the diarrhea will improve in the short term. Of course, we must address the main issue of intussusception, and the diarrhea can be temporarily disregarded. We only need to perform air enema reduction and mainly resolve the intestinal obstruction and intussusception through surgical treatment. Diarrhea, because it is treated with IV fluids and some intestinal anti-inflammatory medications, will naturally subside.

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Written by Yao Li Qin
Pediatrics
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How is intussusception diagnosed?

Intussusception is one of the common acute abdominal conditions in infants and young children. The primary clinical symptoms include abdominal pain, vomiting, and "jam-like" stools, with a mass often palpable in the abdomen. Initially, the overall condition of the child is generally fine, but in the later stages, symptoms such as dehydration, lethargy, coma, and shock can appear. Any healthy infant or young child who suddenly experiences episodic abdominal pain or periodic, regular bouts of crying, accompanied by vomiting, bloody stools, and a sausage-shaped mass in the abdomen, should be highly suspected of having intussusception. Once intussusception is confirmed, timely enema treatment should be administered to the child, and if the opportunity for an enema has passed, surgical treatment should be considered.