Intussusception (Inpatient)

Intussusception (In-TUSS-uh-SEP-shun) is a blockage of the intestines. It happens when one part of the intestine folds into another part. In most cases the cause is not known. It may occur any time between 3 months and 5 years of age, but is more common in children younger than 18 months. It tends to run in families. If one child has had intussusception, brothers and sisters are more likely to have it. Even with treatment, there's a 10% chance that it could happen again.

Signs of Intussusception

• Pain in the abdomen (tummy) that comes and goes, or comes on suddenly.

• The child pulls his or her legs up to the chest.

• "Jelly" type stools, sometimes with blood.

• Abdomen is distended (puffed out) or rigid.

• Child may be listless (hard to wake up).

How It Is Diagnosed

• X-ray of the abdomen.

• Sometimes a sausage-like mass can be felt in the tummy. This is the folding of the intestine.

Treatment

Many intussusceptions are fixed with an air enema. A tube is put into the child's rectum so the doctor can look at the intestines with a special X-ray. Many times the area that has folded over itself unfolds when the air moves through it. Usually if this happens, the child is placed in an observation unit and sent home later in the day.

Or the child could be admitted to the hospital and another X-ray taken the next day. This is done to make sure that the intestine does not fold into itself again. Then the child is sent home from the hospital that day.

Surgery

If the air enema does not unfold the intestine, your child will need to have surgery. During surgery, the doctor will make an incision into your child's abdomen. The part of the intestine that is folded inward will be unfolded. The doctor will gently pull it into the normal position. Your child will then be taken to the PACU (Post Anesthesia Care Unit), also called the Recovery Room, to wake up.

After Surgery

After your child wakes up in the PACU, he will be taken to a room on the surgical unit.

Your child may have a tube in his nose that goes into his stomach. This tube helps air pass out of his stomach. While this tube is in place, your child will not be able to eat or drink anything. After the tube is taken out, he will be given clear liquids at first. If he keeps these down, other liquids, including formula or breast milk, may be given. Be sure to tell your nurse if you are breast-feeding so you can use a breast pump to save your milk for your baby.

• Your child will receive medicine for pain through an IV (intravenous) line.

• There will be a clear bandage over the place where the incision was made. The Steri-Strips™ (thin strips of sticky tape) over the incision will come off on their own in about a week.

• Your child will stay at the hospital for 3 or 4 days before going home.

• Although very rare, it is possible for your child to have intussusception again.

Pain Medicine after Surgery

Doctor's Order

• Your child's doctor has prescribed acetaminophen, _______ mg. Tylenol®, Feverall® and Tempra® are some of the brand names of this medicine.

• Follow the instructions on the label to find the number of tablets or amount of liquid to give your child.

• This medicine should be given every 4 hours while your child is awake for the next 3 days if he has pain.

• If your child has severe pain that is not relieved by acetaminophen, call your doctor.

• Do not give your child ibuprofen, such as Children's Motrin® or Children's Advil®, without asking your doctor first.

• Side effects are rare, but if your child has nausea or vomiting, skin rash or bruises, stop giving this medicine and call your doctor.

Safety Tips and Other Advice

• Read the label each time before you give your child this medicine.

• Give the exact amount of medicine as ordered by your doctor.

• If the medicine is a liquid, use a pediatric measuring device (available at the pharmacy) to measure the exact dose. Do not measure liquid medicines in kitchen spoons.

• Stay with your child until he or she has swallowed the dose of medicine.

• Do not give more than 5 doses of this medicine in a 24-hour period unless ordered by your doctor.

• Store all medicine out of the reach of children.

• If your child or someone else takes too much of this medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TDD 614-228-2272). They will tell you what to do.

When to Call the Doctor

Call your doctor if your child has:

• Fever over 101 F

• Increasing pain

• Swelling, redness, or drainage from the incision

• Any signs of intussusception coming back.

If you have any questions, call __________________________________ or the Nationwide Children's Hospital operator at (614) 722-2000 and ask for the "surgeon on call".

Intussusception Inpatient (PDF)

HH-I-193 5/97, Revised 6/14 Copyright 1997, Nationwide Children's Hospital