Intussusception should visit which department?

Written by Bai Yan Hui
Pediatrics
Updated on February 09, 2025
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Intussusception generally falls under pediatric surgery, but many children arrive at the hospital without a clear self-diagnosis of intussusception; they often come due to abdominal pain. They can visit either the internal medicine department or the surgical department. At this point, the attending physician will conduct a thorough medical history inquiry, such as a standing abdominal radiograph, abdominal ultrasonography, and physical examination, to aid in diagnosis. If a diagnosis confirms the need for surgical intervention, whether it involves air enema or surgery, it is definitely within the scope of the surgical department.

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Written by Hu Qi Feng
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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 Zhang Peng
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Causes of Intussusception in the Elderly

Intussusception refers to an obstruction caused by one segment of the intestine entering an adjacent segment, which can occur at any age. In adults, over 85% of intussusception cases can be attributed to organic lesions, typically tumors, but also possibly due to polyps or diverticula in the intestines. Typical symptoms of intussusception may include abdominal pain, an abdominal mass, and jelly-like bloody stool. In adults, intussusception is generally treated surgically. The surgical approach often involves exploratory laparotomy, possibly involving intestinal resection and anastomosis. For the resected part, reinforced suturing is usually required. If a primary anastomosis cannot be tolerated, procedures such as creating a stoma or exteriorizing the intestine may be performed, awaiting stabilization of the condition before further treatment.

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Written by Quan Xiang Mei
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What tests need to be done for intussusception?

Intussusception is a common surgical disease in infants and young children, characterized clinically by crying, abdominal pain, abdominal distention, the passage of jelly-like stools, and vomiting. Auxiliary examinations for this condition primarily involve abdominal ultrasonography, though occasionally an abdominal X-ray can be performed. If a child experiences intussusception, treatment can vary depending on the severity; mild cases might be treated with an air enema. However, if the symptoms of intussusception are severe and prolonged, leading to ischemic necrosis of the intestines, surgical intervention is definitely required. In summary, the examination for intussusception primarily involves abdominal ultrasonography.

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Written by Yan Xin Liang
Pediatrics
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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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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.