What to Do If Your Baby Has Intussusception

Intussusception in infants is a medical emergency requiring prompt recognition and intervention. This condition occurs when one segment of the intestine telescopes into an adjacent segment, leading to bowel obstruction, compromised blood flow, and potential tissue necrosis if left untreated.

Infants aged 6 to 36 months are most commonly affected, with peak incidence between 6 and 12 months. Classic symptoms include paroxysmal abdominal pain—manifested as sudden, inconsolable crying episodes—often accompanied by vomiting, lethargy, and passage of “currant jelly” stool, which reflects intestinal mucosal hemorrhage and sloughing. However, presentation can be atypical, especially in younger infants, who may exhibit only pallor, irritability, or decreased activity without overt gastrointestinal signs.

Diagnosis relies primarily on abdominal ultrasound, which demonstrates the pathognomonic “target sign” or “doughnut sign” representing the concentric layers of invaginated bowel. In select cases, contrast enema (using air or water-soluble contrast) serves both diagnostic and therapeutic purposes: it confirms the diagnosis while simultaneously attempting nonoperative reduction of the intussusception.

Nonoperative reduction via air or contrast enema is successful in approximately 70–90% of cases when performed early—ideally within 24–48 hours of symptom onset—and in the absence of peritoneal signs, shock, or evidence of perforation. Contraindications include suspected bowel perforation, peritonitis, or hemodynamic instability, which necessitate immediate surgical consultation.

Surgical intervention—typically laparoscopic or open reduction—is indicated for failed enema reduction, recurrent intussusception, or complications such as bowel ischemia, perforation, or necrosis. In severe cases, resection of nonviable bowel segments may be required. Post-reduction, infants require close observation for recurrence, which occurs in roughly 5–10% of cases, most often within the first 72 hours.

While most pediatric intussusceptions are idiopathic, clinicians should remain vigilant for underlying pathologic lead points—such as Meckel’s diverticulum, lymphoid hyperplasia (e.g., post-viral), or, rarely, polyps or tumors—particularly in older children or those with atypical presentations or recurrence.