Intussusception in Babies and Children
Content reviewed against published AAP, NIH, CDC guidelines
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Intussusception is a serious condition in which one segment of the intestine telescopes (invaginates) into an adjacent segment, like a collapsing telescope. This causes bowel obstruction, cutting off blood supply to the affected section. It is the most common cause of intestinal obstruction in children between 3 months and 6 years of age, with peak incidence at 5-10 months. It is a medical emergency requiring prompt treatment.
Key takeaways
- Intussusception is a serious condition in which one segment of the intestine telescopes (invaginates) into an adjacent segment, like a collapsing telescope.
- Duration: After successful air enema reduction, children typically recover within 24 hours and are observed overnight. After surgical reduction, hospital stay is 3-5 days. Without treatment, intussusception can lead to bowel death within 24-48 hours.
- Go to ER if: Classic pattern: episodes of severe pain with lethargy between (do not wait)
- No vaccine currently available
Symptoms
How It Presents by Age
0-3 months
Less common but can occur. May present primarily with lethargy and poor feeding rather than classic pain episodes. Can be difficult to diagnose in very young infants. Structural lead points are more common in this age group.
Risk level: High — often diagnosed late
3-12 months
Peak incidence age. Classic presentation: sudden-onset episodic severe crying/pain every 15-20 minutes, with quiet/lethargic periods in between. Knees drawn to chest. Vomiting. Currant jelly stool is a late sign.
Risk level: High — most common age
1-3 years
Second most common age group. Classic colicky pain pattern. May describe or point to tummy pain. Currant jelly stool and sausage-shaped abdominal mass may be detected. Often preceded by recent viral illness.
Risk level: Moderate to high
3-6 years
Less common. When occurring in older children, more likely to have a structural lead point (polyp, lymphoma, Meckel diverticulum). Should prompt investigation for underlying cause after reduction.
Risk level: Moderate — investigate for lead point
Treatment
Air or hydrostatic enema reduction
First-line treatment: air (pneumatic) or barium/saline enema performed under fluoroscopy. Successful in 80-95% of cases. Air is guided into the colon under controlled pressure to push the telescoped bowel back to normal position.
Surgical reduction
Required if enema reduction fails, if there are signs of perforation or peritonitis, or if the child is hemodynamically unstable. Open or laparoscopic surgery to manually reduce the intussusception or resect non-viable bowel.
IV fluid resuscitation
Aggressive IV hydration before and during treatment. Many children are dehydrated from vomiting and poor intake.
Nasogastric decompression
NG tube placed if there is significant vomiting or abdominal distension to decompress the stomach.
Bowel resection
If a segment of bowel has lost blood supply and become necrotic, surgical removal of the dead segment with reconnection (anastomosis) is required.
Home Care
- There are NO home remedies for intussusception — this is a MEDICAL EMERGENCY
- Seek emergency medical care immediately if you suspect intussusception
- Do not give food or drink if intussusception is suspected (the child may need a procedure)
- Note the timing and duration of pain episodes for the medical team
- Bring any unusual diaper contents (currant jelly stool) to show the medical team
- After successful reduction: watch closely for recurrence (same symptoms) — this occurs in 5-10% of cases within 72 hours
When to Worry
Go to the ER if:
- Classic pattern: episodes of severe pain with lethargy between (do not wait)
- Currant jelly (red, mucousy) stool
- Bilious (green) vomiting with abdominal pain
- Child becomes limp and lethargic between pain episodes
- Abdominal distension with vomiting
- Signs of shock: pale, rapid heart rate, cold extremities, weak
- Bloody stool with severe intermittent abdominal pain
- Recurrence of symptoms after previous intussusception reduction
Call your doctor if:
- Sudden-onset intermittent abdominal pain in an infant or toddler
- Unusual lethargy in a baby between pain episodes
- Any blood in stool with abdominal pain
- Repeated vomiting with intermittent pain
Keep an eye on:
- Sudden-onset severe abdominal pain that comes and goes every 15-20 minutes
- Baby draws knees to chest and screams in pain
- Periods of extreme lethargy between pain episodes
- Red or blood-tinged stool
- Jelly-like red/maroon stool (currant jelly stool)
- Child becomes progressively more lethargic
- Vomiting that becomes green (bilious)
Prevention
- There is no known way to prevent most cases of intussusception
- Be aware of the symptoms, especially in the 3-12 month age group
- Seek prompt medical attention for sudden-onset intermittent abdominal pain
- The rotavirus vaccine carries a very small increased risk (1-5 extra cases per 100,000 infants) — the benefits of vaccination far outweigh this minimal risk
- After a successful reduction, watch for recurrence for 72 hours
Contagion & Incubation
Incubation
Not applicable. Onset is acute, often following a viral respiratory or GI illness by a few days.
Contagious for
Not contagious.
Duration
After successful air enema reduction, children typically recover within 24 hours and are observed overnight. After surgical reduction, hospital stay is 3-5 days. Without treatment, intussusception can lead to bowel death within 24-48 hours.
Frequently asked questions
How long does intussusception last?
How does intussusception spread?
When should I take my baby to the ER?
Can intussusception be prevented?
When can my child return to daycare?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Illnesses
Bottom line
Intussusception is treatable with appropriate medical care. Seek emergency care if classic pattern: episodes of severe pain with lethargy between (do not wait).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.