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Treatments for Intussusception

Intussusception (rare in adults) is the telescoping of one part of the bowel into another, most commonly the last part of the small intestine into the cecum of the large intestine at the ileocecal valve, causing swelling, inflammation and impaired circulation. The bowel becomes obstructed, and bleeding and mucous above the obstruction cause your child (usually birth to 6 years) to pass "currant jelly" stool.

  1. Supportive Care

    • When your child suddenly develops symptoms, usually including abdominal pain, vomiting and eventually currant jelly stools, X-rays and ultrasound of the abdomen may show the blockage. According to Mayo Clinic, your child will receive intravenous fluids to replace fluids lost from vomiting and the inability to take fluids. If he has a fever or signs of infection, he may receive antibiotics. He will receive blood tests to check the level of his electrolytes (sodium, potassium, phosphorus), so the physician can correct imbalances. If your child's abdomen is distended (a sausage-shaped mass is usually noticeable) and painful, the physician probably will insert a nasogastric tube down the nose, through the stomach and into the small intestine to drain liquid stool that builds up because it can't get by the obstruction caused by the intussusception.

    Hydrostatic Enema

    • Occasionally, the intussusception corrects itself spontaneously, but most children require treatment. If your child is not in shock and has no signs that the bowel has ruptured (torn), she will receive a rectal enema, with barium (most common), air or water-soluble contrast dye. As the enema solution flows up the colon, the hydrostatic pressure of the fluid is often enough to push the telescoped portion of the bowel back into place, reopening the bowel. However, the intussusception can recur, requiring additional hydrostatic enema or surgery, so she must be monitored very carefully after the procedure.

    Surgery

    • Your child may need surgery if the hydrostatic enema does not correct the intussusception or your child shows signs of shock, such as pallor, rapid pulse, low blood pressure, lethargy and clammy skin. Sometimes the blood supply to the bowel is cut off and the tissue begins to die, eventually causing the wall of the bowel to rupture and spill liquid stool into the abdomen. This causes a severe infection (peritonitis). If your child has signs of shock, peritonitis, or necrotic (dying) bowel, a surgical repair is necessary because an enema could cause further damage or rupture the bowel if it is still intact. Sometimes the damaged portion of the bowel must be removed. Even after surgery, an intussusception may recur.

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