Intussusception – Diagnosis and Treatment
Diagnosis
Doctors often begin diagnosing intussusception with a health history and a physical exam to check for common signs such as abdominal pain, vomiting, a swollen belly, or a sausage-shaped lump that they can sometimes feel.
They may look for additional symptoms like bloody stool, fever, and signs of bowel obstruction, especially in children under the age of three.
Infants may pull their knees to their chest, cry intermittently, or show signs of fatigue between episodes of pain. Because symptoms may come and go, itโs important to observe patterns and changes over time.
To confirm the diagnosis, doctors use several imaging techniques:
| Imaging Test | Purpose |
|---|---|
| Ultrasound | Shows the “bull’s-eye” pattern |
| X-ray | Reveals blockages or swelling |
| CT scan | Gives detailed images of the bowel |
These tests help confirm intussusception, identify the presence of a palpable mass, and rule out similar conditions like peritonitis, appendicitis, or acute intestinal obstruction. In cases where the diagnosis is unclear, imaging also helps determine the severity and exact location of the problem.
Doctors may also run blood tests to check for signs of infection, dehydration, or electrolyte imbalance, especially if the patient is very sick or has been vomiting repeatedly.
Managing Intussusception
Doctors treat intussusception as an urgent medical problem. Quick actions lower the risk of serious problems like dehydration, shock, or damaged bowel tissue.
Common treatment methods include:
| Treatment | When Used | Success Rate |
|---|---|---|
| Air/Barium Enema | Children, no bowel tear | ~90% |
| Surgery | Adults, failed enema, bowel tear, lead point | Required in those cases |
Air or Barium Enema: Doctors use this method for both testing and treating. An enema is often the first choice, especially for children. It can fix the issue in nearly 90% of cases. However, doctors avoid using an enema if there is a hole or tear in the intestine. If the condition comes back, they can repeat the enema.
Surgery: Surgeons operate if the enema does not work, the intestine is already torn, or there is a specific blockage, known as a lead point. During surgery, they release the trapped part of the intestine. Sometimes, they remove a piece of the bowel (bowel resection) if it is too damaged. For adults and those who are very ill, surgery is usually the main choice.
In rare situations, intussusception may resolve without treatment, especially in very mild or transient cases. However, this is unpredictable, and most cases still require prompt evaluation to avoid complications.
Observation may be considered in older children or adults who have no symptoms or only very mild signs, but this is done cautiously and under medical supervision.
After successful treatment, doctors monitor for signs of recurrence, which can happen in a small number of cases, especially in the first 24โ48 hours. Patients may also receive IV fluids, pain relief, and in some cases, antibiotics to prevent or treat infection.
Specialists such as pediatric surgeons, radiologists, and gastroenterologists work together to determine the best treatment based on the patientโs age, symptoms, and overall condition.
Getting Ready for Your Visit
Questions Your Healthcare Provider Might Ask
Doctors will want to learn more about the symptoms and health history. Expect questions like:
- When did the stomach pain or other symptoms start?
- Does the pain stay the same or come and go?
- Does the pain begin and end quickly?
- Has there been any nausea, vomiting, or diarrhea?
- Is there any blood seen in bowel movements?
- Have you noticed any lumps or swelling in the abdomen?
It helps to write down answers before the visit to make the appointment smoother.
Steps to Take Before You See the Doctor
While you wait for emergency care, do not give any over-the-counter medicine or food if you suspect intussusception. Watch for signs like sudden stomach pain, vomiting, or changes in stool, and take these seriously. If you notice these symptoms, seek immediate help from a healthcare provider.
