Intussusception: What it is, Symptoms & Treatments

An intestinal blockage and colicky abdominal pain result from the condition known as intussusception, in which one segment of the intestine slides into another like a telescope. It typically happens where the small and big intestines meet. It can induce edema and,if not treated promptly, result in permanent intestinal damage.

What causes intussusception, and how common is it?

Intussusception’s exact cause is not known. It is believed that an intestinal virus infection causes the gut lining to expand and leak into the intestine below. This typically occurs during the weaning phase. Intussusception can also result from polyps or diverticula that some kids are born with. The typical age range is between 3 and 36 months. However, it can happen at any age, particularly if it’s caused by a polyp. One in 1200 kids will eventually develop it,and boys are likelier to do so.

What are the symptoms?

Excessive crying is brought on by the acute and cramping type of stomach pain, which causes the baby to frequently curl and pull his legs up to his chest. This may linger for a short while,interspersed with painless intervals. Rectal bleeding (red, jelly-like stools), which can occasionally be accompanied by mucous, might start unexpectedly, which is quite distressing and concerning for parents. Frequent vomitings occur, which eventually may containbile. Some patients may experience abdominal distension.

How it is diagnosed?

Occasionally, a physical exam will reveal an abdominal lump. The mass can be located via ultrasonography.

How is intussusception treated?

Surgical and non-operative treatments are the two options for intussusception. It could be possible to try reduction (pushing the intestine back) if intussusception is identified within a few hours of the onset of symptoms using a liquid contrast enema or an air contrast enema (the same techniques that are used for diagnosis).Since this is a radiologic operation rather than a surgical one, the patient won’t require anesthesia. The success rate of the liquid contrast enema and air contrast enema operations is between 60 and 70 per cent, and the return of intussusception occurs between 6 and 10 per cent of the time. Depending on the equipment and experience available in a particular arrangement, it is done under either fluoroscopy or ultrasound supervision.

They have a low risk of complications, as well. If a radiologic reduction is unsuccessful, then the patient will need surgery.

• Surgery may also be done if there is a great deal of infection or the patient is too ill for the radiologic procedure.
• Surgery is done under general anesthesia.
• In suitable places, laparoscopic surgery can also be helpful depending upon the availability of facilities and experienced laparoscopic pediatric surgeons.
• Alternatively, open surgery can be done through an incision on the right side of the abdomen, and the intestine is pushed back into its normal position.
• If the intussusception cannot be reduced, the surgeon may have to remove the irreversibly damaged segment of the bowel.

Are there any alternatives to surgery?

The previously mentioned non-operative treatments are only effective when the infant is born early or within 48 hours. It can be attempted for up to 72 hours in some circumstances. Later, the likelihood of problems rises.

What are the possible complications/ what happens after the surgery?

To ensure your child is comfortable following surgery, pain medication is administered. The intestines are temporarily halted, so the child will need IV fluids for a few days. During this time, feedings are not provided. Depending on their preoperative condition and the ease of reduction, the majority of children gradually resume eating by the same day or the following day.
Resuming feedings may take several days if the gut needs to be removed.When the child is able to digest regular food, is fever-free, has no drainage from the wound, and has normal bowel function, they are prepared to be discharged from the hospital. Before returning to their regular activities, most kids need to take a few days or weeks of rest at home.

What is the outlook of these children?

A follow-up is required for several weeks after surgery to evaluate recovery and look for any complications.
The usual complication that can happen is adhesions and obstruction after surgery or a recurrence of intussusception where surgery is not done but the radiological reduction was done.In the long term, intussusception patients usually do well without any deleterious effects on the health and well-being of the child. Only patients with certain syndromes, especially elder children with intestinal polyps, need a regular follow-up for the development in case of recurrence or malignancy in the polyps.