Intussusception: How to Diagnose

Written by Yao Li Qin
Pediatrics
Updated on January 19, 2025
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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 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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Written by Quan Xiang Mei
Pediatrics
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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 Hu Qi Feng
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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Written by Bai Yan Hui
Pediatrics
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Intussusception should visit which department?

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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Does intussusception require a CT scan?

Intussusception is commonly diagnosed through routine abdominal ultrasound examinations, which have a positive rate of over 90%. In the ultrasound, the transverse section of the intussusception can show concentric circles or target ring-shaped mass images, and the longitudinal section may reveal the sleeve sign. Additionally, a barium enema can be employed, along with X-ray imaging. Under X-ray, the lead point of intussusception appears as a mass shadow, and air enema reduction treatment can be performed concurrently. Generally, CT is not used as a routine diagnostic tool.