Intussusception is a condition where one segment of the intestine slides into another, like a telescope collapsing, obstructing the flow of food and blood supply. It's a common cause of acute bowel obstruction in children under 2, especially between 3 and 9 months old, occurring more frequently in boys.

Doctor Nguyen Do Trong, from the Pediatric Surgery Department at Tam Anh General Hospital in Ho Chi Minh City, explains that intussusception causes food and digestive fluids to stagnate, blocking blood flow to the affected intestinal section. This causes the blocked section to swell rapidly, potentially leading to bowel obstruction, infection, internal bleeding, intestinal necrosis, perforation, septic shock, increased risk of peritonitis, and even death.

The symptoms can be easily mistaken for common digestive issues, leading to delayed intervention and dangerous complications. Here are some warning signs.

Severe, intermittent abdominal pain occurs in episodes lasting 15-20 minutes, with cyclical cramping. The onset is often sudden in otherwise healthy children who may be playing and then abruptly cry out in pain. During these episodes, the child might have a flushed face, writhe, and pull their legs up to their stomach. The pain may subside briefly before returning, repeating multiple times with increasing duration.

Vomiting is a common symptom, appearing soon after the pain begins. Initially, the child vomits food, and later, green or yellow fluid.

Bloody stools with a fishy odor are a key indicator that distinguishes intussusception from other digestive problems. This symptom usually appears 6-12 hours after the onset, caused by ruptured capillaries in the compressed intestinal section.

A swollen abdomen, pulsating with slow, shallow or rapid breathing, may present a palpable, firm, banana-shaped mass, usually in the upper or right abdomen.

Lethargy, refusal to feed, mild fever, and reduced alertness can appear as intussusception progresses. These signs indicate the body's response to inflammation or lack of blood supply to the intestines.

Bluish skin, progressing to a blue-purple hue within hours, cold and pale extremities, and signs of severe dehydration like dry skin, dry lips, sunken eyes, rapid shallow breathing, and loss of consciousness signal late-stage intussusception.

Doctor Trong (center) and the surgical team operating on a child. Illustrative photo: Dinh Lam.

Doctor Trong notes that not all children with intussusception exhibit all these symptoms. About 5-10% may not experience noticeable abdominal pain. Some might not have bloody stools or an abdominal mass, and in some cases, the intussusception might prolapse through the anus.

The cause of intussusception in children under 2 is mostly unknown. It's less common in older children, where potential causes include Meckel's diverticulum, duplication cysts, intestinal polyps, intestinal tumors, abnormal intestinal structure, mesenteric lymphadenitis, enteritis, intestinal adhesions, or immunodeficiency. Introducing solid foods can also alter intestinal motility, increasing the risk. Pre-existing intussusception or a family history of the condition also elevates the risk.

If intussusception is suspected, doctors perform a clinical examination, possibly combined with ultrasound and abdominal X-rays. Treatment depends on the timing of diagnosis and the child's health. If diagnosed within 24 hours, most cases can be resolved with air or liquid enema. In later stages, with intestinal necrosis or perforation, surgery is necessary to remove the damaged section and reconnect the intestine.

According to Doctor Trong, there's no definitive preventive measure for intussusception. Parents should educate themselves about the condition and observe their child for symptoms. Exclusive breastfeeding for the first 6 months is recommended to strengthen immunity. Close monitoring is crucial during the introduction of solid foods or after a viral gastroenteritis infection. Children should receive all recommended vaccinations from the Ministry of Health to boost their immune system. If a child shows unusual signs like excessive crying, vomiting, bloody stools, or abdominal distension, parents should seek immediate medical attention.

Trinh Mai