Diagnosis

Your or your child's doctor will start by getting a history of the symptoms of the problem. He or she may be able to feel a sausage-shaped lump in the abdomen. To confirm the diagnosis, your doctor may order:

  • Ultrasound or other abdominal imaging. An ultrasound, X-ray or computerized tomography (CT) scan may reveal intestinal obstruction caused by intussusception. Imaging will typically show a "bull's-eye," representing the intestine coiled within the intestine. Abdominal imaging also can show if the intestine has been torn (perforated).
  • Air or barium enema. An air or barium enema is basically enhanced imaging of the colon. During the procedure, the doctor will insert air or liquid barium into the colon through the rectum.

    In addition, an air or barium enema can actually fix intussusception 90 percent of the time in children, and no further treatment is needed. A barium enema can't be used if the intestine is torn.

Treatment

Treatment of intussusception typically happens as a medical emergency. Emergency medical care is required to avoid severe dehydration and shock, as well as prevent infection that can occur when a portion of intestine dies due to lack of blood.

Initial care

When your child arrives at the hospital, the doctors will first stabilize his or her medical condition. This includes:

  • Giving your child fluids through an intravenous (IV) line
  • Helping the intestines decompress by putting a tube through the child's nose and into the stomach (nasogastric tube)

Correcting the intussusception

To treat the problem, your doctor may recommend:

  • A barium or air enema. This is both a diagnostic procedure and a treatment. If an enema works, further treatment is usually not necessary. This treatment is highly effective in children, but rarely used in adults.

    Intussusception recurs as often as 10 percent of the time and the treatment will have to be repeated.

  • Surgery. If the intestine is torn, if an enema is unsuccessful in correcting the problem or if a lead point is the cause, surgery is necessary. The surgeon will free the portion of the intestine that is trapped, clear the obstruction and, if necessary, remove any of the intestinal tissue that has died. Surgery is the main treatment for adults and for people who are acutely ill.

In some cases, intussusception may be temporary and go away without treatment.

Preparing for your appointment

Emergency medical care is required to treat intussusception. You may not have much time to prepare for an appointment.

What to expect from your doctor

Your child's doctor is likely to ask you a number of questions, including:

  • When did your child begin experiencing abdominal pain or other symptoms?
  • Does your child's pain appear to be continuous — or is it occurring off and on?
  • Does the pain begin and end suddenly?
  • Has your child experienced nausea, vomiting or diarrhea?
  • Have you noticed any blood in your child's stool?
  • Have you noticed any swelling or a lump in your child's abdomen?

What you can do in the meantime

Don't give your child any over-the-counter medications to treat symptoms before the appointment. Don't give your child anything to eat if you see any of the signs or symptoms of intussusception. Seek immediate medical attention.

Aug. 04, 2017
References
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