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Diseases > Rotavirus
Intussusception
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What is
intussusception?
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Who gets
intussusception?
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What are the symptoms of
intussusception?
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What causes
intussusception?
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Does natural rotavirus infection cause
intussusception?
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Did RotaShield® (rotavirus) vaccine cause
intussusception?
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How is intussusception treated?
Suggested
reading
- 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.
- Who gets
intussusception?
Persons of any age can get intussusception. Intussusception is most
common among infants in the first year of life; 1 in 2,000 to 1 in 3,000
infants is affected before one year of age.
 Top
- What are the symptoms of
intussusception?
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.
- What causes
intussusception?
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.
Top
- Does natural rotavirus infection cause
intussusception?
Some children with intussusception have evidence of recent or current
rotavirus infection. It is not clear if the rotavirus infection caused the
intussusception. Each year there are epidemic of rotavirus gastroenteritis.
In most areas, the number of cases of intussusception does not increase
during these epidemics, suggesting that if rotavirus causes intussusception,
it does so infrequently.
- Did RotaShield® (rotavirus) vaccine cause
intussusception?
Yes. The risk of intussusception increased 20 to 30 times over expected
within 2 weeks following the first dose of RotaShield® vaccine. The risk
increased 3 to 7 times over expected within 2 weeks after the second dose of
RotaShield® vaccine. There was no increase in the risk of intussusception
following the third dose of RotaShield® vaccine, or when three weeks had
passed following any dose of the vaccine. Added to the baseline cases of
intussusception from other causes in the United States (1 in 2000 or 1 in
3000 infants), RotaShield® vaccine is estimated to have caused 1 or 2 cases
of intussusception among each 10,000 infants vaccinated. More
information on RotaShield® and intussusception...
Top
- How is intussusception treated?
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.
Suggested reading:
- Ein SH, Alton D, Padler SB, Shandling B, Stringer D.
Intussusception in the 1990s: has 25 years made a difference? Pediatric Surg
Int 1997;12:374-376.
- Murphy TV, Gargiullo PM, Massoudi MS, et al. Intussusception among
infants given an oral rotavirus vaccine. N Engl J Med 2001;344:564-72.
- Stringer MD, Pablot SM, Brereton RJ. Paediatric
intussusception. Br J
Surg 1992;79:867-876.
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