My cousin, a new parent, is very fond of her 3 month old son. The baby is always cheerful and playful. However, once we found that, despite any apparent reason, the baby kept on crying. Even her mother was not able to soothe her. The baby’s abdomen was looking distended. Suspecting some abdominal ailment, we took the baby to the pediatrician. The pediatrician was glad that we got the baby to him on time. The baby’s intestine had slided into another part of the intestine causing obstruction of the stool as well as the blood supply to the intestine. The condition is termed as intussusceptions. My cousin’s son was treated immediately, and after week his was sent home. He was his self again- cheerful and happy!
About Intussusception
Intussusception is a serious disorder in which the colon or small intestine slides like parts of a telescope into another part of intestine, causing difficulty in the passage of fluid or food through the intestine, and swelling and decreased flow of blood to the intestine. This mostly occurs in children between 3 months to 3 years of age, and for reasons unknown it occurs more in baby boys than baby girls.
Children with intussusception may have pain that comes and goes, and a lump may be felt in the abdomen. Due to the severe abdominal pain, the child may pull the legs towards the chest and cry loudly, a sign that one needs to look out for. Each episode of pain lasts for 15 to 20 minutes.The abdomen becomes swollen and distended. The child may vomit a greenish yellow color vomitus; there could be diarrhea leading to dehydration. The stool has a “currant jelly” like appearance meaning that there is blood and mucus present in the stools. The child can also have high fever. The child may seem drowsy and irritable.
Causes
The exact cause of intussusception in children is not known, but it is observed that trigger factors like viral infection, stomach flu (gastroenteritis), cancerous tumor in intestine, and non cancerous growth can cause intussusception. Intussusception is seen mostly during seasons like spring and fall, during which children generally catch upper respiratory infections. It has been observed that it also occurs when children are introduced to solid foods for the first time. Introducing new foods to the child may cause swelling of lymph tissue in the intestine leading to intussusception .
Diagnosis
The doctor may conduct a general physical examination to check for any lump in abdomen and distension of abdomen. To check for blood in stools, fecal occult blood test and urine tests are done. In a procedure known as CT scan (computerized tomography) cross sectional images of the abdomen are taken with help of x rays to check for any intestinal obstruction due to intussusception. Similarly, Ultrasound of abdomen is done in which sound waves of high frequency are used to get images of abdomen. To check if there is any perforation in the intestine, abdominal imaging is done. In a procedure called air or barium enema, the doctor sends liquid barium or air into the colon through rectum of the child which makes the x rays clear. Sometimes, the enema clears intussusception requiring no further treatment.
Treatment
Intussusception must be treated as a medical emergency. The child can be in shock and dehydration. So as soon as the child is brought to the hospital, IV fluids (intravenous fluids) are given to stabilize the child’s condition. A nasogastric tube (tube from nose to stomach) is inserted to decompress the intestines. If the air or barium enema does not solve the problem then surgery is recommended in which the surgeon will clear the intestinal obstruction and also remove the intestinal tissue that is dead due to lack of blood supply on account of intestinal obstruction.
Complications
Intussusception can cause severe complications, if left untreated. The longer you take time for treatment, the worse the condition of the child will get. If treated within the first 24 hours after symptoms of intussusception have appeared, the recovery is complete with no complications. Delaying treatment can lead to complications like perforation of the intestine, irreversible tissue damage, infection of tissue, and even death. A perforation in the intestine can cause infection in the lining of abdominal cavity which is known as peritonitis and is a life threatening condition. The symptoms of peritonitis include abdominal swelling and pain, thirst, fever, and low urine output. The child can go into a shock due to peritonitis.
Calling the doctor
You must consult the doctor as soon as you see symptoms of intussusception without any delay. In case the child goes into a shock, you may observe symptoms like cold and clammy skin, blank eyes, slow breathing, rapid and weak pulse, skin turns pale or grey and profound listlessness. The child may be unconscious in this state.
