Intussusception is a common cause of blockage in the intestine in young children. It is rarer in adults and is usually due to an underlying condition.
The condition can cause pain and severe complications. Doctors can treat it with surgery or other approaches.
Read on to find out symptoms, causes, treatments, and differences in adults and children.
According to the BMJ Best Practice, Intussusception occurs when one part of the intestine slides into the next section. This causes it to fold around itself, similar to the way parts of a telescope fit into each other.
It is a common cause of intestinal obstruction in young children. Although rare, it may still occur in adults. It usually occurs in the small intestine, or at the junction where the small intestine meets the large intestine.
This causes a blockage in the intestine, which can cut off the blood supply and make it difficult for food and drink to pass through.
It is a serious condition requiring medical treatment. Intussusception can lead to:
- death of tissue
- a tear in the intestine wall
Children and adults usually present symptoms in the same way. However, in children, it usually has a sudden onset, while in adults, symptoms can be nonspecific and develop over a longer period.
The following describes typical symptoms.
A paper in the Journal of Pediatric and Neonatal Individualized Medicine refers to three classic symptoms for intussusception in children. These include:
- cramping abdominal pain
- bloody diarrhea
- a tender mass that a doctor can feel
However, having all three symptoms is quite rare, occurring in less than 15% of children with intussusception.
Younger children may not be able to describe their symptoms. They may also draw their knees to their chest and cry out in pain due to the symptoms coming on suddenly.
Because there is a blockage in the intestine, it may lead to tissue death or perforation, which could then cause an infection. Peritonitis is an infection in the lining of the abdominal cavity.
A child who has peritonitis may develop sepsis and go into shock. This is life-threatening and requires urgent medical attention.
Adult symptoms of intussusception can be non-specific and develop over a more extended period. They can include:
- abdominal pain
- constipation, diarrhea, or change in bowel habits
- abdominal mass
- blood in the feces
However, the above symptoms could also be due to another condition. Intussusception in adults is usually secondary to another cause.
A person who has any of these symptoms should contact their doctor. If they experience severe and sudden pain, they should seek urgent medical attention.
Research into intussusception in children indicates that it can occur during development or because of an infection. However, the cause is sometimes unknown.
In adults, intussusception is often due to an associated condition that causes a ‘lead point.’ This is something that makes the intestine catch and telescope in on itself.
Some causes can be:
Intussusception is more common in children than in adults. It mainly occurs in children 6–18 months. Roughly 30% of all cases occur in children older than 2 years.
The condition is rare in adults, accounting for 1–5% of bowel obstruction cases.
Children usually have the classic symptoms described above, while adults often present non-specific chronic symptoms that may be due to partial obstruction. Adults show more variation in symptoms than children.
In children, intussusception usually has no known cause, with only 10% of cases having an identifiable cause. In contrast, 90% of adults with intussusception develop it as a result of an underlying condition.
Young children are more at risk of intussusception.
According to the American Pediatric Surgical Association, 75% of cases in children occur in the first 2 years of life. It also occurs more frequently in males.
One source suggests that risk factors for intussusception in children may include:
- cystic fibrosis
- intestinal polyps
The same source suggests the following risk factors for adults:
- bowel adhesions
- intestinal tumors
A family history or a previous episode of intussusception can also put someone more at risk.
A doctor will ask a person about their symptoms, and if they suspect that a person has intussusception, they might recommend imaging tests, such as:
Treatment will depend on a range of factors, such as the severity of the symptoms and a person’s age. Usually, a doctor will consider a non-surgical procedure first.
A barium or saline enema may be a sufficient method to treat intussusception. The pressure from the enema can push the telescoped part of the intestine back to its correct position.
In children, treatment with an enema usually resolves 85–90% of cases. This can also be an option for adults.
After treating children with an enema, doctors, parents, or caregivers must carefully observe the child as recurrence may happen within the first 24 hours.
A doctor may recommend surgery if the enema treatment is ineffective, there are signs of bowel tissue necrosis, or to treat the underlying cause of intussusception.
The surgeon may be able to restore the intestines to their normal position.
If the surgery causes damage to the bowel tissue, the surgeon may need to perform a surgical resection. This is where the surgeon removes the damaged tissue and sews the remaining healthy sections together.
Surgical and non-surgical treatments usually have a good outcome.
In cases where intussusception caused tissue death in the bowel, a person may develop complications. However, these are usually rare.
People who have had intussusception before may get it again, particularly if another condition triggers it. A doctor must address any underlying health issues to prevent a recurrence.
Children experiencing pain or any of the symptoms described above should see a doctor urgently. Leaving intussusception untreated can lead to severe complications..
Adults who have sudden severe pain should also see a doctor immediately. Intussusception can cause longer-term symptoms that a person may confuse with another condition.
Underlying conditions may also be serious, such as cancer.
Typically, a doctor can treat intussusception with an enema. If this does not work, a person may require surgery.