Intussusception is a serious condition that causes bowel problems in children and adults. It occurs when one part of the intestine slides inside another section like a telescope.
When this happens, it can block food or fluid from passing through the intestine. In some cases, it can cut off the blood supply to the affected area. If this condition isn’t treated it can lead to an intestinal injury, infection, internal bleeding and even death.
Intussusception is one of the most common abdominal emergencies in children under 2 years of age. Boys are four times as likely to develop intussusception than girls. The cause of this condition in children is usually unknown. In adults, it typically develops as a result of an underlying condition such as tumors, polyps, a viral infection or after recent abdominal surgery.
What are the symptoms of intussusception?
Children with intussusception may have intense abdominal pain that often begins suddenly. They may:
- Draw their knees up toward their chest
- Cry very loudly
- Vomit blood or red mucus
- Have jelly-like stool
Pain from intussusception can go away for short intervals, and the child may switch from extreme irritability to being calm or even playful during this time. Children with symptoms of this condition should be seen by a doctor as soon as possible.
How is intussusception diagnosed?
Symptoms of intussusception are similar to those of other medical conditions, which can make it difficult to diagnose. A physical examination can reveal a sausage-shaped mass in the abdomen. Doctors also use imaging tests such as:
- Abdominal X-rays. Imaging that shows if the bowel has telescoped or if there is obstruction.
- Abdominal ultrasound. Imaging that uses sound waves to create pictures of what’s happening inside the body.
- Air-contrast barium enema. An X-ray combined with air and a contrast fluid given as an enema. This can show, and sometimes correct, intussusception or blockages.
How is intussusception treated?
In some cases, the pressure of the air-contrast barium enema can push the intestine back into its normal position. However, in about 10% to 15% of cases this does not work and surgery is necessary.
Surgeons may be able to gently return the intestine to its original position and prevent it from telescoping again. If this is not possible, or if a portion of the intestine has been permanently damaged, the affected section is usually removed.
The severity of the intussusception and the specific treatment determine how long the patient stays in the hospital as well as the recovery period.
Can vaccines cause intussusception?
Studies have shown a link between the rotavirus vaccines and intussusception in young children. This happens very rarely, with between one in 20,000 and one in 100,000 children in the U.S. developing intussusception after a rotavirus vaccine. Symptoms usually begin within a week of receiving the vaccine.
The National Vaccine Injury Compensation Program (VICP) lists intussusception from the rotavirus vaccine in its vaccine injury table. According to this table, if a child develops intussusception between one and 21 days after receiving the first or second dose of this vaccine, the condition is presumed to have been caused by the vaccine. If certain criteria are met, compensation may be available for this vaccine-related injury.