Intussusception: Before and after surgery

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Learn more about intussusception and how you can properly care for your child before and after surgery.

Key points

Intussusception occurs when a part of the intestine folds into itself like a telescope. This prevents the passage of food through the intestine.
Your child will not be able to eat or drink while under assessment for intussusception.
Your child will be given a general anaesthetic before surgery. This will ensure your child stays asleep throughout the surgery.
For pain relief, give your child acetaminophen or ibuprofen for the first 24 hours. Follow the instructions on the bottle.
If you have any urgent concerns following surgery, take your child to the nearest Emergency Department.

Introduction

What is intussusception?

Intussusception (IN-tuh-suss-SEP-shun) occurs when a part of the intestine folds into itself like a telescope, with one segment slipping inside another segment. This causes a blockage, preventing the passage of food through the intestine. When the "telescoped" section of the intestines is pressing on each other for a long period of time, it can cause irritation and swelling. This can cut off the blood supply to the intestines and cause serious damage. Symptoms of intussusception may include: severe pain, vomiting or passing bloody and/or jelly-like stools. If your child's doctor thinks your child has intussusception, the doctor will do a physical exam and history and order an ultrasound.

Location of small and large intestines in a child and close-ups on a normal intestine and an intestine with intussusception — Intussusception occurs when part of the intestine folds in on itself. This commonly occurs where the large intestine meets up with the small intestine.

Procedure overview

Treatment of intussusception

If your child has intussusception, the doctors will then decide on a treatment plan. This may include an air enema and/or surgery.

Air enema

An air enema is performed in the X-ray department by a radiologist. During the air enema, a small, soft tube is placed in the rectum and air is passed through it. The air travels into the intestines and attempts to unfold the bowel that has "telescoped," fixing the intussusception. The doctors may have to repeat the air enema to be successful. Your child will remain in the emergency room for observation. If the doctors decide an air enema is not appropriate, or the air enema(s) are not successful, the decision to take your child to surgery may be made.

Preparing for the procedure

What to bring to the hospital

Your child will already be staying in the hospital, so you do not need to bring anything on the day of the operation. But you may want to bring a toy that is special to your child. On the day they are released from the hospital, bring your child's car seat for the ride home.

Taking time off from work

It is difficult to plan how much time you will need to take off work. In most cases, however, you should be able to go back to work after about one week.

Before the surgery

Your child will not be allowed to eat or drink while under assessment for intussusception. This is especially important before surgery. Your child will have blood drawn and an intravenous (IV) inserted. The IV will keep your child hydrated. Also, the doctors will ask you for consent regarding surgery and will go over the risks of the surgery.

Procedure

During the surgery

Your child will be given a general anaesthetic. This ensures that your child remains asleep through the surgery and prevents them from feeling any pain. Your child will also receive a dose of antibiotics through their IV before the surgery.

During the surgery, the surgeon will free the portion of the intestine that is telescoped and, if necessary, remove any of the intestinal tissue that has been damaged. Depending on the situation, the operation may be done laparoscopically (using several small incisions) or open (using a larger incision).

The incision(s) will be closed using small pieces of tape called Steri-Strips.

After the procedure

After the surgery

After the surgery, your child will go to the Post-Anaesthetic Care Unit (PACU) or recovery room to wake up. You may visit your child once they wake up. Upon waking up, they will go to an inpatient unit.

Your child may have a tube in their nose called a nasogastric (NG) tube, which will help keep their stomach empty while the bowels heal. Your child will receive pain medication through their IV after surgery to keep them comfortable.

Bringing your child home

Your child can go home when:

their heart rate, breathing, blood pressure and temperature are normal
they are able to eat without vomiting (throwing up)
they are comfortable taking oral (by mouth) pain medicine

Helping your child

Taking care of your child at home

Care of the incision

The incisions from the surgery will be covered by a dressing called Steri-Strips. You do not need to do anything to the Steri-Strips. A small amount of old blood on the Steri-Strips is common. If the blood seems fresh or the amount of blood increases, press on the area with a clean washcloth for five minutes. Then call your child's surgeon's office. If the bleeding does not stop, take your child to a family doctor or to the nearest Emergency Department.

The Steri-Strips will fall off on their own. You may remove the Steri-Strips if they have not fallen off seven to 10 days after the surgery.

Activities

Your child can return to normal activities once they feel able.

Diet

Your child should be able to return to their normal diet after the surgery. If they have problems eating, call your surgeon's office.

Pain medicine

When your child comes home, you may want to give them acetaminophen or ibuprofen for the first 24 hours after surgery. Follow the instructions on the bottle for the amount of medicine to give them.

Bathing

You can give your child a bath 48 hours after surgery.

Going back to daycare or school

Your child can return to daycare or school when they feel comfortable, and you are comfortable with them returning to their normal routine.

When to seek medical attention

When to call the surgery team

After you have gone home you will need to watch for signs of infection and signs that intussusception has recurred (the intussusception has come back). The risk of recurrence (the intussusception coming back) is about 10% and is greatest within the first 48 hours following the intussusception being fixed. The risk of recurrence is much lower if a piece of intestine has been removed at the time of surgery.

Please call your surgeon's office if you see any signs of infection. These include:

fever of 38°C (100.4°F) or higher
redness around the incision
drainage from the incision is yellow or green and has a foul smell
swelling at the incision site
increasing pain around the incision site.

Please call your surgeon's office if you see any signs of recurrence. These include:

vomiting
blood in the stool or stools that look like currant jelly
abdominal pain
fever of 38°C (100.4°F) or higher
abdominal distension (a swollen tummy)
irritability or difficulty settling.

If you have a question or a concern that is not urgent, call your child's surgeon's office during business hours or leave a message on the answering machine after hours. If you have an urgent concern, take your child to their family doctor, paediatrician or the nearest Emergency Department.