Intussusception

What is intussusception?

Intussusception is when one section of the intestines slides into another section of the intestines, like a handheld telescope folding into itself. This causes a blockage in the intestines, called an obstruction. Intussusception can involve the small intestine, large intestine, or both.

Obstruction of the intestines leads to food and liquid getting stuck and may cut off the supply of oxygen and nutrients to the intestines by blocking blood vessels. If left untreated, the obstruction can permanently damage the intestinal tissue. In severe cases, a tear or perforation in the intestines can occur.

What causes intussusception?

Most causes of intussusception are unknown, but one possible cause is viral or bacterial infections of the intestines. These infections can cause swollen lymph nodes and increase the risk of the intestines folding into themselves. Some other conditions can increase the risk of intussusception, including cystic fibrosis, inflammatory bowel disease (IBD), abdominal surgeries, intestinal polyps, cysts, or diverticula in the intestines.

When does intussusception occur in children?

Intussusception is most common in children between 3 months and 5 years of age. However, intussusception can occur at any age.

What are the symptoms of intussusception?

Symptoms of intussusception are the result of blockage in the intestines. Typically, children will have sudden, severe, intermittent, and worsening belly pain over time. Pain is often so severe that children cannot be soothed or consoled. Children also might draw their legs toward their belly to help with the pain. Because the pain can come and go, children can behave normally between episodes.

Vomiting is also a common symptom of intussusception. Vomiting may start as clear or yellow in color, but may become dark green if the blockage gets worse. Stools also may become bloody, and in severe cases, may resemble currant jelly. Other symptoms include fatigue that can come and go, and small sausage-shaped lumps on the belly.

How do you diagnose intussusception?

Diagnosis starts with your child’s doctor taking a thorough history of your child’s symptoms. The doctor also may order a test called an ultrasound or computed tomography (CT) scan to better see the intestines. An ultrasound can provide a quick image of the intestines. A CT scan provides more detailed images of the intestines and other organs, but requires radiation. Neither test usually requires sedation. If a child has an ultrasound or CT scan between pain episodes, the test may not show an obstruction. Because the symptoms of intussusception can look like other diseases, your child’s doctor also may need to perform bloodwork to help make a diagnosis.

How do you treat intussusception?

Depending on the location in the intestines, intussusception can either be watched without treatment or treated with an enema. Placing an enema is safe, temporary, and can be done with or without general anesthesia. The type of enema and if anesthesia is needed will be determined by your medical team, including your child’s gastroenterologist, a radiologist, and possibly a surgeon.
Placing an enema involves inserting gas or liquid directly into your child’s rectum. This is usually done with the help of imaging tests, which together can both confirm the diagnosis and treat the intestinal blockage. The enema may be repeated multiple times to treat your child’s symptoms and avoid surgery.

What happens after intussusception is treated with an enema?

If the enema procedure is uncomplicated and your child can drink normally, they can often go home after being briefly monitored by their medical team after the procedure. Antibiotics are not usually given unless there is a specific concern for infection or other complications. If the enema did not reduce the obstruction or if intestinal tearing occurs, your child may be admitted to the hospital to discuss other treatments like surgery.

Will my child need surgery?

Intussusception can usually be managed without surgery, but a surgeon may be needed if:

• Your child is extremely ill.
• There is concern that the intestine will tear.
• Non-surgical treatment has been unsuccessful.
• Your child has had previous and returning episodes of intussusception that required treatment.

Author: Andrew Ebanks, MD
Editor: Amanda Deacy, MD
June 2025