From the Guidelines
Intussusception in infants typically presents with intermittent, severe abdominal pain, vomiting, and bloody stools, and requires immediate medical attention as it constitutes a medical emergency. The classic triad of symptoms includes:
- Intermittent, severe abdominal pain causing a previously healthy infant to suddenly draw up their legs and cry inconsolably, often followed by periods of normal behavior
- Vomiting, which may become bilious (green or yellow) as the condition progresses
- "Currant jelly" stools—bloody, mucus-containing bowel movements resembling red jelly Other symptoms may include:
- Abdominal distension
- A palpable sausage-shaped mass in the abdomen
- Lethargy
- Fever Early symptoms may be subtle, with pain episodes lasting 2-3 minutes and occurring every 10-20 minutes 1. As the condition worsens, the infant may become increasingly irritable, develop signs of dehydration, and eventually show signs of shock if left untreated 1. Intussusception is most common in infants 5-10 months old and occurs when one portion of the intestine telescopes into an adjacent segment, causing obstruction, reduced blood flow, and potential intestinal damage 1. It is essential to recognize these signs and symptoms to provide prompt medical attention and prevent complications. In some cases, intussusception can be associated with other conditions, such as Peutz-Jeghers syndrome, which is characterized by multiple gastrointestinal polyps and mucocutaneous freckling 1. However, the primary concern is to address the intussusception promptly to prevent morbidity and mortality. Therefore, any infant presenting with these symptoms should be evaluated immediately for intussusception.
From the Research
Signs and Symptoms of Intussusception in Infants
The signs and symptoms of intussusception in infants can vary, but common presentations include:
- Abdominal pain or colic 2, 3, 4, 5, 6
- Vomiting 2, 3, 4, 5, 6
- Rectal bleeding or bloody stools 2, 3, 4, 5, 6
- Lethargy 2, 4, 6
- Irritability 2
- Abdominal mass 4, 6
- Fever 4
Classic Triad
The classic triad of abdominal pain, hematochezia, and palpable abdominal mass is seen in a few patients 4, but it is often absent 2, 3, 5.
Importance of Early Diagnosis
Early diagnosis of intussusception depends on a high level of clinical suspicion in any child with non-specific abdominal findings, followed by appropriate radiographic or ultrasonographic evaluation and confirmation with a contrast enema 4.
Diagnostic Tools
Diagnostic tools for intussusception include:
- Ultrasound, which is a safe, sensitive, and specific test for the diagnosis of intussusceptions 4
- Contrast enema, which is the gold standard for diagnosis and first-line treatment of intussusception 2, 4
- Abdominal radiography, although it lacks the sensitivity to reliably exclude the presence of intussusception 4