This is one of the most serious, and potentially most dangerous surgical emergencies of childhood. It is most common between the ages of five and twelve months. It is not often seen and most family doctors will see only a small number of cases in their professional lifetime, unless dealing with large numbers of infants. In most cases no specific cause can be found.

The chief event is telescoping of one part of the bowel into the part of the bowel that follows on. It can only get worse, and the risk is that the blood supply to the telescoped part is impaired. If this happens, the bowel will die. It is essential that the bowel be disentangled as urgently as possible. Necrosis (death) of the affected part of bowel may take place within 12 to 36 hours.

Symptoms are usually clear cut. The child appears fit and healthy. Then there is a sudden onset of sharp recurring abdominal pain. It comes and goes. The child tends to perspire with the discomfort and draws the legs up in an attempt to gain relief from the pain. For the first two hours, the child seems all right in the pain-free intervals between the attacks. Vomiting may set in, but not necessarily. The condition tends to become progressively more severe with the passage of time.

A fever sets in. After five hours or more, the patient becomes dehydrated. The eyes tend to sink in. Often a sausage-shaped mass can be detected in the abdomen by the doctor, when carefully felt. If there is a bowel action, it may have a dark red coloration.


With symptoms of this nature, urgent medical attention is essential. Never neglect abdominal pain occurring in a child. This is even more vital in a normally healthy child who suddenly complains. If associated with vomiting, a fever or abnormal bowel actions, the situation becomes more acute. Surgery is the usual method of treatment. When carried out early, the results are excellent. The longer the child is left, the higher the risk factor, and the chances of a prompt, successful outcome progressively lessen also.


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