Typical symptoms of intussusception in children

Written by Hu Qi Feng
Pediatrics
Updated on February 13, 2025
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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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Is intussusception in children serious?

Intussusception is a life-threatening emergency, and its reduction is an urgent treatment measure that should be performed immediately once diagnosed. In the early stages, the child generally appears healthy, with normal body temperature and no obvious symptoms of poisoning. However, as the condition progresses and the duration of the intussusception increases, it can lead to intestinal necrosis or peritonitis, causing a deterioration in the overall condition. Commonly, severe dehydration, high fever, coma, shock, and other serious symptoms of poisoning may occur.

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General Surgery
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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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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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Pediatrics
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Intestinal intussusception described by ultrasound.

The appearance of intussusception under ultrasound shows concentric or target ring-shaped mass images on a transverse section scan, and a sleeve sign on a longitudinal section scan. For an ultrasound-guided hydrostatic reduction, a balloon is inserted through the anus and inflated, connecting a T-tube to a Foley catheter with a side tube connected to a sphygmomanometer to monitor water pressure. Isotonic saline at a temperature of thirty to forty degrees is injected, and the target ring-shaped mass image can be seen retracting to the ileocecal region. The disappearance of the concentric circles or sleeve sign under ultrasound indicates the completion of this therapeutic diagnosis.

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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.