Intussusception is a common cause of intestinal obstruction in children. When a child has an intussusception, a segment of small intestine intermittently telescopes into the next segment of bowel. The movement of the bowel facilitates this in and out action, until the bowel becomes so swollen that it gets stuck. According to the Mayo Clinic website, intussusception is the most common cause of intestinal obstruction in children. This is primarily a childhood condition, although it has happened in adult patients.
Pain
Children with intussusception present with intermittent episodes of colicky abdominal pain. This pain mirrors the waves of intestinal movement, also known as peristalsis. With each wave, more intestines get trapped inside the other segment of bowel. Each wave is followed by a period of relaxation of the bowel, which corresponds to a pain-free period for the child. Children with this problem usually have periods of severe abdominal pain, during which they pull up their legs against their chest and cry inconsolably, followed by periods when they appear well. These episodes of pain are frightening to both the child and the parents, especially since the child appear well between episodes. As the intussusception worsens, the pain-free periods diminish and the child appears ill.
Vomiting
Once the intestine becomes blocked, the child will exhibit symptoms of bowel obstruction. The main symptom is vomiting. Initially, the child vomits undigested food, but as the illness progresses, the child starts vomiting yellow-green bile. The vomiting eventually leads to dehydration, which can then progress to electrolyte imbalances and affect the child's kidneys.
Abdominal Mass
Once the bowel gets stuck, an examiner can detect a sausage-shaped mass in the right upper quadrant of the abdomen. This is best felt during the pain-free episodes, when the child relaxes her abdominal wall.
Stool Changes
Some children with intussusception will exhibit diarrhea as a symptom. The stool can be liquid and have microscopic or occult blood, which can be detected with a bedside hemoccult test. According to a study in the Archives of Pediatric and Adolescent Medicine, rectal bleeding is a significant finding associated with intussusception. If the intussusception is not corrected in time, bowel ischemia occurs and the child will have currant-jelly stools with mucous and blood. This finding virtually pinpoints the diagnosis, but it is a late finding, associated with loss of blood supply to the segment of bowel affected.
