What is intussusception?
Intussusception (pronounced in-tuss-uss-EPP-shun) happens when 1 segment of the intestine (bowel) slides into the segment next to it, like a telescope. This often blocks the movement of food or fluid through the bowel. When this happens, the flow of blood to the affected area can also be cut off. Sometimes this leads to infection, a hole or even death of part of the bowel.
Intussusception is an emergency that needs to be treated right away. Call your doctor right away, or bring your child to our Emergency Department if they have severe pain in their belly or bloody stools.
Each year we treat many children with intussusception, often without surgery.
Contact our Pediatric General and Thoracic Surgery Department at 206-987-2794 if you have questions about intussusception treatment or care after surgery.
Seattle Children’s has the lowest rate of surgery on children with intussusception in the state. For most children, we use an air or liquid enema to open the bowel.
If your child needs an operation, our surgeons are experts at intussusception repair. Because our surgeons have done so many cases, they have greater skill and can best decide when surgery is needed. This adds up to better outcomes.
Our Emergency Department offers round-the-clock access to Seattle Children’s specialists and the full facilities of our hospital.
Children differ from adults in how they react to illness, medicine, pain and surgery. They need – and deserve – care designed just for them. That is why our surgeons are all board certified in pediatric surgery.
We do tests, radiation and surgery only as needed. We use radiation doses lower than recommended by the American College of Radiology.
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We take time to explain your child’s condition. We help you fully understand your treatment options and make the choices that are right for your family.
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Intussusception almost always causes pain in the belly. Your child may cry and draw their knees up to their chest. In many cases, the pain:
- Is intense
- Starts suddenly
- Comes in waves about every 15 minutes
- Tends to get worse each time it returns
Your child may also:
- Have poop (stool) mixed with blood and mucus. It can look like currant jelly.
- Have a swollen lump in their belly.
- Be tired or act sluggish.
- Have a fever.
- Ask about your child’s symptoms and health history.
- Check your child for a lump in their belly.
- Check for signs of dehydration and shock.
Often, the doctor will do imaging studies of your child’s belly to look for problems in their bowel. The radiologist will decide which test is best for your child. These may include:
First, doctors will make sure your child is stable. They may:
- Give your child fluids through an intravenous (IV) line.
- Place a tube through their nose into the stomach (nasogastric tube or NG tube) to release air trapped in the bowel.
If tests show your child has an intussusception, we will give them an air or contrast enema. Some children also need surgery.
Doctors place a soft rubber tube in your child’s rectum and send air or a contrast liquid into their bowel. The X-rays made during the process help show us where the bowel is blocked.
Often, pressure from the air or contrast enema pushes the bowel back into place. This avoids the need for surgery. In 8% to 20% of children, intussusception happens again in the next 2 days. Those children need to be treated again.
Before your child goes home, we watch them for 4 hours to make sure they can drink liquids without having any pain.
Surgery for Intussusception
Your child will need surgery if:
- Doctors are worried that the lining of your child’s belly is infected (peritonitis).
- The enema does not push the bowel back into place.
- Your child has a structural problem with their bowel.
Contrast enemas using air or liquid are useful even if they don’t open your child’s intussusception. Doctors use the X-ray images to plan for surgery.
At the time of surgery, we will give your child medicine (general anesthesia) to make them sleep without pain. The doctors at Seattle Children’s who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to give anesthesia to children safely.
There are two types of surgery for intussusception. Your child’s surgeon will talk with you about the best type for your child:
- Through 3 or 4 tiny cuts. This is called laparoscopic surgery.
- Through 1 larger cut (open surgery).
After making the cut in your child’s belly, the surgeon will:
- Free the trapped segment of bowel.
- Remove any blockage.
- Cut out any part of the bowel that is dead or has severe damage and then sew the sections back together.
After surgery, we will give your child pain medicine to make them comfortable. It takes some time for their bowel to recover. How soon your child can eat or drink will depend on the type of surgery they had. Your child will be ready to go home when they:
- Can eat a normal diet for their age
- Have no fever or drainage from the surgery site
- Have a bowel movement
Most children can go home 1 or 2 days after their operation. If your child has a more complex operation, they may stay in the hospital 5 to 7 days.
Before your child goes home, the surgery team will:
- Teach you how to keep your child’s incision clean and dry until it heals.
- Explain what kinds of food or medicine to give your child.
- Tell you if you need to limit your child’s activity for a while. School-age children will need a few days of rest at home before going back to school. They should wait 2 weeks before they return to gym class and sports.
Between 1% and 5% of children have intussusception again after surgery. We will tell you symptoms to watch for.
You will need to bring your child in for a checkup visit 2 to 4 weeks after their surgery. We will check that your child’s incision is healing and they are recovering well.