JAMA PATIENT PAGE The Journal of the American Medical Association

GASTROINTESTINAL DISEASES
Intussusception Intussusception

I ntussusception occurs when a portion of the small or large

intestine slides forward into itself, like a telescope. An
intussusception can block flow through the intestines and
also limit the blood supply to that area of intestine. It is most
commonly seen in children who are younger than 1 year. The
cause is usually unknown, but an intussusception can follow viral
gastroenteritis (an infection) or intra-abdominal surgery or be caused
by a tumor in the intestine. Although intussusceptions can occur Small
anywhere in the small or large intestine, they are most commonly Colon intestine
found near the transition from the small intestine to the large
intestine. These types of intussusception are called ileocolic
intussusceptions. The February 8, 2012, issue of JAMA includes an Blood supply
article about the risk of intussusception and rotavirus vaccines. to intestine

SIGNS AND SYMPTOMS

• Children with intussusceptions suddenly develop severe abdominal
pain with vomiting at frequent intervals.
• During the episodes of pain, they may draw their knees up to their Colon
abdomen while crying.
• They may appear well in between episodes of pain.
• If the intussusception is not treated, symptoms can worsen to include Small
intestine
bilious (dark green) vomit and bloody stool (often called currant jelly
stool because of its appearance).
DIAGNOSIS Constricted
blood supply
• A history of intermittent severe abdominal pain with vomiting and
bloody diarrhea is highly suggestive of an intussusception.
• On physical examination, the doctor may feel a sausage-shaped mass in
the area of the abdomen that corresponds to the small or large intestine. Colon
• An abdominal ultrasound can confirm a case of intussusception. The
doctor may see evidence of bowel telescoping on itself. On an
ultrasound, this is called a target sign.
TREATMENT
Intussuscepted section
• Once an ileocolic intussusception is diagnosed, it should be treated (reduced) as soon as of small intestine
possible. Physicians often check electrolyte and hemoglobin levels in the child’s blood
and may give intravenous fluids. FOR MORE INFORMATION
• A radiological reduction of the intussusception is usually attempted first. This involves a • American Academy of Pediatrics
contrast enema. Using a catheter (tube), the doctor pushes air or contrast material (a www.healthychildren.org
substance used to make structures like the intestine stand out on a radiological image) • Mayo Clinic
into the bowel through the child’s rectum. This forces the affected segment of intestine www.mayoclinic.com/health
out and into a normal position. /intussusception/DS00798
• Surgery is performed when a contrast enema is unsuccessful or the doctor is concerned
about damage to the intestines. Surgery may involve reducing the intussusception or INFORM YOURSELF
removing the involved intestine. The appendix is often also removed during this
operation. To find this and previous JAMA
Patient Pages, go to the Patient
PROGNOSIS Page link on JAMA’s Web site at
• Early recognition and treatment of intussusception are important to reduce the risk of www.jama.com. Many are available in
damage to the intestine. English and Spanish.
• Children who have had an intussusception are at higher risk of having a recurrence soon Sources: American Academy of Pediatrics,
after reduction. Mayo Clinic

Ann R. Punnoose, MD, Writer
Suman Kasturia, Illustrator Intern
Robert M. Golub, MD, Editor
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628 JAMA, February 8, 2012—Vol 307, No. 6 ©2012 American Medical Association. All rights reserved.

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