1. What is intussusception?

Intussusception is an uncommon type of bowel obstruction that occurs when the bowel folds in on itself. Intussusception is most common among young children. Some cases occur with viral infection, or when a piece of enlarged tissue serves as a "lead point" (e.g., polyp or enlarged lymph gland), but no cause is identified in most cases. The most common place in the intestine for intussusception to occur is where the small bowel joins the large bowel. However, intussusception can occur in many parts of the intestine. With prompt treatment, almost all patients fully recover.

Infants with intussusception become ill with vomiting, abdominal pain and often have blood in the stool. Some infants will have periods of crying in pain alternating with periods of exhausted sleep. Parents of infants with these symptoms should seek medical advice because their infant may require prompt medical evaluation.

In most cases, no cause is identified. Some cases have been associated with infection, such as adenovirus, or with a structural abnormality such as a polyp or tumor.

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An experienced radiologist often can "unfold" the intussusception using an "enema" of air or fluid under pressure to push the enfolded intestine back into its normal position. When this does not work, surgery is required to "unfold" the intestine. In a small percentage of children, it is necessary to remove the section of intestine that is causing the blockage.

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2. Murphy TV, Gargiullo PM, Massoudi MS, et al. Intussusception among infants given an oral rotavirus vaccine. N Engl J Med 2001;344:564-72.
3. Stringer MD, Pablot SM, Brereton RJ. Paediatric intussusception. Br J Surg 1992;79:867-876.