Intussusception

Nithin A. F, Consultant Psychologist, SUT Hospital, Pattom

Intussusception is a common cause of abdominal pain in children. It is commonly seen in children between the ages of 6 months to 3 years. However nowadays it is being seen in older children of 4-7 years also.

What is Intussusception?
Intussusception is the telescoping of a part of the intestine into the adjacent part, for example, the small intestine into the large intestine.

Why does Intussusception occur?
The most common type of Intussusception occurs without any particular reason. Many possible causes have been found like enlargement of the lymph nodes, any cyst related to intestine, any polyp in the intestine, etc. The most common cause of enlargement of lymph glands is starting weaning foods or any infection.

What are the dangers of this condition?
When a part of the intestine enters another part, there will be blockage of the intestine. So the smooth flow of digested food and enzymes is obstructed and the initial part gets dilated or swollen. This causes pain and vomiting.
Also due to a part of intestine getting trapped, the blood flow to that part reduces and may start swelling. That part gets damaged and can even become gangrenous.

What are the symptoms?

• Abdominal pain – The child will have bouts of pain in intervals. Infants will cry uncontrollably during the episodes of pain.
• Vomiting or Refusal of feed – The child may refuse to eat or drink anything. The child may start vomiting. The vomits may even become yellow or green in colour signifying intestinal blockage.
• Blood and mucus in stool – Owing to the swelling of the blocked intestine, bleeding and discharge of mucus may present in stool.
• Danger signs – The child may become dull or pale and become passive with swelling of the abdomen.

Tests to Diagnose
The obstruction may be felt by examining the child.

• Ultrasound scan – This scan can locate the blocked section of intestine and might even identify the cause.
• CT scan – This is helpful in older children who may not have the usual symptoms.

What is the Treatment of Intussusception?
A simple bedside procedure using Saline drip enema under Ultrasound guidance is commonly done. If the condition recurs or this bedside procedure fails, the child will need surgery. Surgical correction is commonly by the open technique. Laparoscopic technique can also be done.

Can this condition occur repeatedly?
This condition can recur or occur again. This is because the intestinal swelling or enlarged lymph glands may not have reduced in size. Some children also have a tendency to develop this condition after sometime. So in children, new weaning foods should be introduced in small quantities and very gradually.