Intussusception most often is treated without surgery. A small number of children do need an operation.
Intussusception Treatment Options
Treatment for intussusception begins with doctors giving your child an enema. The enema may gently push the telescoped section of intestine back to its proper position. Doctors call this treatment "reducing the intussusception."
Doctors at Seattle Children's usually try to fix the problem with an air enema first. They put air into the intestine through a tube placed in your child's anus.
If this doesn't work, doctors may try a liquid enema. The liquid contains dye that shows up on an X-ray. This is called a contrast enema. It may work even if the air enema did not. Contrast enemas are useful even if they don't push your child's intestine into place. The X-rays made during the process help doctors see where the blockage is. They may help with surgery.
If enema treatment works, your child most likely will stay in the hospital overnight. This way we can make sure your child is able to eat food and pass stool.
Surgery for Intussusception
If the enema doesn't work, your child will need surgery right away. Your child may also have surgery before having an enema if the doctor thinks the intestine has been damaged by the intussusception. This is not common, though.
At the time of surgery, we will give your child medicine to make them sleep without pain (general anesthesia). Then the surgeon will make a cut, or incision, in your child's belly. The surgeon may do this operation:
- Through three or four tiny cuts (laparoscopic surgery)
- Through one larger incision (open surgery)
Your child's surgeon will talk with you about which option may be best for your child.
Then the surgeon will squeeze the telescoped intestine back into place, if possible. If the intestine is severely damaged or cannot be squeezed back into place, the surgeon will cut out the damaged section and sew the loose ends together. Very often, surgeons remove the child's appendix during this operation.
The length of the surgery depends on what your child needs. It takes 30 minutes to an hour, sometimes longer. Your child will be in the recovery room for another hour.
After Surgery for Intussusception
After surgery, we will give your child pain medicine to make them comfortable. It takes some time for the intestine to recover after surgery. You can expect your child to stay in the hospital at least overnight. They may need to stay for up to a week. How soon your child can eat or drink will depend on the type of surgery.
After your child goes home, you'll need to keep the incision clean and dry until it heals. The surgery team will teach you how to care for the incision, explain what kinds of food or medicine to give your child, and tell you if you need to limit your child's activity for a while. Between 1% and 5% of children get intussusception again, so you will need to watch for symptoms.
About two to three weeks after surgery, your child will need to see the surgeon for a follow-up visit. The surgeon will make sure the incision is healing and your child is recovering well.