Intussusception

Intussusception occurs when one segment of the intestine telescopes into an adjacent segment, causing a blockage and cutting off blood supply to the affected part. It is a surgical emergency and one of the most common causes of bowel obstruction in young children.

• Sudden onset of severe, colicky abdominal pain, causing the child to draw up their legs and cry, occurring in episodes with pain-free intervals between
• Vomiting, which may become bile-stained as the condition progresses
• Passage of blood and mucus in the stool, sometimes described as looking like "redcurrant jelly"
• Lethargy between episodes of pain, which can be a concerning sign
• A sausage-shaped lump may sometimes be felt in the abdomen on examination

• Most commonly occurs in infants and young children, typically between three months and three years of age, often without an identifiable specific cause.
• Can sometimes follow a recent viral gastrointestinal infection, which may cause swelling of intestinal tissue that triggers the telescoping.
• Less commonly, in older children, a specific structural cause within the intestine may be identified.

• Suspected clinically based on the characteristic pattern of episodic abdominal pain, vomiting, and blood in the stool in a young child.
• Abdominal ultrasound, where available, is the key diagnostic test, showing a characteristic appearance that confirms the diagnosis.
• Prompt diagnosis is important, as delay increases the risk of the affected bowel losing its blood supply.

Intussusception is a medical emergency requiring urgent hospital admission.

In many cases, the intussusception can be reduced (untelescoped) using a non-surgical procedure — an enema performed under imaging guidance — which is both diagnostic and therapeutic when successful.

If non-surgical reduction is not successful, or if there are signs of bowel that has already lost its blood supply, emergency surgery is needed to manually reduce the intussusception or remove any non-viable bowel.

Supportive care, including intravenous fluids and pain relief, is provided throughout, and children are monitored closely for recurrence, which can occur even after successful treatment.

• Seek immediate medical care for a young child with sudden, severe, episodic abdominal pain, especially with vomiting or blood in the stool.
• There is no specific way to prevent most cases of intussusception, since a clear cause is often not identified, making prompt recognition and urgent care the most important protective step.
• Complete routine childhood vaccination as scheduled, and discuss any specific concerns about vaccine-related risk with a health worker, since rotavirus vaccination timing is carefully chosen partly with this rare risk in mind.