Intussusception is a serious disorder in which part of the intestine slides into an adjacent part of the intestine. This "telescoping" often blocks food or fluid from passing through. Intussusception also cuts off the blood supply to the part of the intestine that's affected. Intussusception can lead to a tear in the bowel (perforation), infection and death of bowel tissue. Intussusception is the most common cause of intestinal obstruction in children younger than 3.
Intussusception generally occurs between ages 6 mo and 3 yr, with 65% of cases occurring before age 1 and 80 to 90% occurring before age 2. It is the most common cause of intestinal obstruction in this age group. Most cases are idiopathic. However, there is a slight male predominance as well as a seasonal variation; peak incidence coincides with the viral enteritis season. An older rotavirus vaccine was associated with a marked increase in risk of intussusception and was taken off the market in the US. The newer vaccines, when given in the recommended sequence and timing, are not associated with any clinically significant increased risk. In about 25% of children who have intussusception, typically very young and older children, a lead point (ie, a mass or other intestinal abnormality) triggers the telescoping.
An enema is the first step in treatment. In fact, an enema that is used to diagnose intussusception may also help to treat it. Pressure from the air or fluid may cause the intestine to correct itself. The result of an enema treatment might not last, so patients usually stay in the hospital overnight for observation. Surgery is another treatment option. Intussusception surgery involves either a large incision or a small incision and a camera. This is called laparoscopic surgery. The type of surgery depends on the location and severity of the obstruction. Intussusception surgery may include removal of the affected section of intestine. There were 210 discharges with a diagnosis of intussusception over this period with 197 individual patients. There were 8 patients who accounted for 13 repeat admissions. 6 patients were incorrectly coded and excluded. 2 further patients who had prior operative resection in the Pacific Islands and who were transferred for postoperative management were excluded. This left 189 patients for analysis.