Symptoms, Causes in Children & Adults

Intussusception happens when a part of your intestines folds back on itself.

Around 90% of intussusception cases occur in children under 3, while only 5% occur in adults. The most common symptoms are abdominal pain, nausea, and vomiting.

Intussusception is the most common abdominal emergency in children. It is the second leading cause of bowel obstructions for this age group.

The symptoms of intussusception are slightly different for adults and children. Here is how to recognize the condition in both kids and adults:

Symptoms in Children

Symptoms in children tend to come on suddenly. Some common symptoms in children include:

Symptoms in Adults

The symptoms in adults include:

Healthcare providers have difficulty finding a cause for intussusception in children. Only about 10% of cases have determined causes—usually a physical problem of the small intestine or a viral or bacterial infection.

The physical problem can be anything that results in a slight change in the intestine’s structure. For instance, if the intestine is too empty or rigid, it may fold in on itself. In children, causes of a physical problem of the intestines include:

• Abnormal growths like benign or cancerous tumors, polyps, or cysts
• Birth defects in the digestive tract
• Diseases and disorders such as cystic fibrosis
• Surgery
• Meckel’s diverticulum, which occurs when the umbilical cord doesn’t close after birth, leading to a small pouch in the small intestine

A healthcare provider can identify the cause of intussusception in adults 90% of the time. The most common reason is an abnormal growth in your intestines, such as a tumor or polyp. Other causes in adults are abdominal adhesions from surgery or a disease such as cystic fibrosis, celiac disease, and Crohn’s disease.

Your healthcare provider will ask questions about your symptoms and health history, and then do a physical exam. Depending on your symptoms, they may look for:

• Bloating in your abdomen
• A lump or mass in your abdomen
• Tenderness or pain in your abdomen
• Sounds in your abdomen
• Signs of complications, such as dehydration or shock

Imaging tests are used to find and confirm an intussusception. These tests include an ultrasound and computed tomography (CT) scan. An ultrasound is usually used first, especially for children, because it is noninvasive.

• Abdominal ultrasound: Your intestines are viewed from different angles to find abnormalities
• CT scan: Your intestines are viewed in greater detail

Intussusception needs to be treated immediately. While your prognosis is good with treatment, if left untreated, intussusception can be fatal in 2-5 days.

Treatment differs slightly in children and adults because of age and the typical location of the intussusception. In children, intussusception usually happens in the large intestine. In adults, it occurs more often in the small intestine. In either case, the goal of treatment is to undo or remove the intussusception.

Children

An enema, the typical first step in treatment for children, is 70-95% effective.

During an enema, your healthcare provider inserts a tube through your anus. They use ultrasound or X-ray imaging to guide the tube to the area of your intussusception. Your intestine is then filled with air or fluid to stretch out the fold gently. (A pneumatic enema uses air and a hydrostatic enema uses fluid.)

Children usually remain at the hospital after the enema because there is a 10% risk of the intussusception returning in the first 24 hours after the procedure. If the enema is unsuccessful, immediate surgery is necessary. The recurrence rate is 5-10% when surgery is not performed, but it is close to zero with surgery.

Adults

Treating intussusception in adults requires surgery because the intussusception is typically due to another medical issue, such as a tumor causing intestinal blockage. A surgeon removes the blockage and the intussusception.

Because the cause of intussusceptions in children is usually unknown, prevention is difficult. All you can do is watch for symptoms of possible recurrence. Children typically get intussusception at 6-18 months, meaning they probably won’t be able to verbalize when something hurts and where it hurts.

Prevention is also challenging in adults because there is usually another underlying medical condition causing the intussusception. Fortunately, intussusception is rare in adults, and your recurrence rate is minimal. Eating a high-fiber diet and staying well-hydrated may reduce the risk of intussusception and prevent recurrence.

Intussusception needs to be treated immediately. When the walls of your intestines are pulled and pushed together, it causes blood flow restriction, irritation, and swelling. If left untreated, there can be serious complications, such as:

• Intestinal obstruction: The folded part of your intestine can cause a blockage
• Dehydration: The absorption of water and nutrients is affected
• Necrosis: Irreversible cell injury and tissue death can occur from the lack of blood flow
• Intestinal perforation: A hole forms in the wall of your intestine
• Peritonitis: An infection of the lining of the abdominal cavity
• Sepsis: A serious illness resulting from your immune system’s overwhelming response to an infection
• Shock: A life-threatening condition from the lack of blood flow in the body

Intussusception occurs when a part of your intestines folds in on itself.

It typically occurs in children younger than 3 years old. When it occurs in adults, it is usually due to an underlying medical issue.

Intussusception needs to be treated immediately. Treatment is either an enema or surgery to remove the intussusception. Treatment is usually successful, and the recurrence rate is low.