How is intussusception diagnosed?

Written by Yao Li Qin
Pediatrics
Updated on March 01, 2025
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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.

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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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Can infants with intussusception sleep?

Intussusception presents as abdominal pain, which occurs in sudden, severe, and periodic episodes. The child cries restlessly with a pale face, and the pain lasts several minutes or longer. The pain then subsides, and during this relief, the child falls asleep. The pain reoccurs every ten to twenty minutes. Continuous episodes occur until the intussusception is successfully reduced, after which the child calms down and falls asleep without further crying or vomiting.

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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 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.

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How to treat intussusception in infants

The treatment of intussusception mainly includes non-surgical and surgical methods. The non-surgical method involves enema treatment. Within 48 hours of the onset of intussusception, if the overall condition is good, there is no abdominal distension, no apparent dehydration, and no electrolyte disorders, ultrasound-guided hydrostatic enema, air enema, or barium enema can be performed. If the intussusception lasts more than 48 to 72 hours, or if the duration is shorter but the condition is severe, with intestinal necrosis or perforation, surgical treatment is required.