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Intussusception Medication

  • Author: Felix C Blanco, MD; Chief Editor: Carmen Cuffari, MD  more...
Updated: Mar 03, 2016

Medication Summary

Drug therapy is not currently a component of the standard of care for intussusception. Medications are limited to those used for pain control after surgery. In the immediate postoperative period, weight-adjusted intravenous morphine is usually administered. As the oral diet is resumed, acetaminophen with codeine or ibuprofen is given orally.

Patients with HSP or hemophilia and intussusception require standard therapy for the individual disease. Some investigators have advocated the use of steroids in intussusception secondary to HSP and lymphoid hyperplasia, with varied results.


Opioid Analgesics

Class Summary

Opioid analgesics are used to control acute crisis and chronic pain.

Morphine sulfate (Duramorph, Astramorph, MS Contin, Avinza, Kadian)


An opioid analgesic, morphine interacts with endorphin receptors in the CNS.

Acetaminophen with codeine (Tylenol-3)


This is a mild narcotic analgesic. Provide the family with a small supply for use when pain severity is greater than what can be managed with acetaminophen alone. Counsel parents to use only for severe pain, not as the first medication for each symptom.


Nonsteroidal Anti-Inflammatory Drugs

Class Summary

These agents add to the effects of opioids during painful crises and allow use of lower doses of narcotics.

Ibuprofen (Advil, Motrin)


Ibuprofen is usually the drug of choice for the treatment of mild to moderate pain, if no contraindications exist. It inhibits inflammatory reactions and pain by decreasing the activity of the enzyme cyclo-oxygenase, resulting in inhibition of prostaglandin synthesis.

Contributor Information and Disclosures

Felix C Blanco, MD Research Fellow, Department of Surgery, Children’s National Medical Center

Felix C Blanco, MD is a member of the following medical societies: American College of Surgeons

Disclosure: Nothing to disclose.


Garry Wilkes, MBBS, FACEM Director of Clinical Training (Simulation), Fiona Stanley Hospital; Clinical Associate Professor, University of Western Australia; Adjunct Associate Professor, Edith Cowan University, Western Australia

Disclosure: Nothing to disclose.

Lonnie King, MD Consulting Staff, Department of Emergency Medicine, Children's Healthcare of Atlanta at Scottish Rite

Lonnie King, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Emergency Physicians

Disclosure: Nothing to disclose.

A Alfred Chahine, MD Associate Professor of Surgery and Pediatrics, George Washington University School of Medicine and Health Sciences; Chief of Pediatric Surgery, Georgetown University Medical Center; Attending Surgeon, Children's National Medical Center

A Alfred Chahine, MD is a member of the following medical societies: American College of Surgeons, International Pediatric Endosurgery Group, American Medical Association, American Pediatric Surgical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

B UK Li, MD Professor of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Medical College of Wisconsin; Attending Gastroenterologist, Director, Cyclic Vomiting Program, Children’s Hospital of Wisconsin

B UK Li, MD is a member of the following medical societies: Alpha Omega Alpha, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

Disclosure: Nothing to disclose.

Chief Editor

Carmen Cuffari, MD Associate Professor, Department of Pediatrics, Division of Gastroenterology/Nutrition, Johns Hopkins University School of Medicine

Carmen Cuffari, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Royal College of Physicians and Surgeons of Canada

Disclosure: Received honoraria from Prometheus Laboratories for speaking and teaching; Received honoraria from Abbott Nutritionals for speaking and teaching.

Additional Contributors

Hisham Nazer, MB, BCh, FRCP, , DTM&H Professor of Pediatrics, Consultant in Pediatric Gastroenterology, Hepatology and Clinical Nutrition, University of Jordan Faculty of Medicine, Jordan

Hisham Nazer, MB, BCh, FRCP, , DTM&H is a member of the following medical societies: American Association for Physician Leadership, Royal College of Paediatrics and Child Health, Royal College of Surgeons in Ireland, Royal Society of Tropical Medicine and Hygiene, Royal College of Physicians and Surgeons of the United Kingdom

Disclosure: Nothing to disclose.

  1. Bonnard A, Demarche M, Dimitriu C, et al. Indications for laparoscopy in the management of intussusception: A multicenter retrospective study conducted by the French Study Group for Pediatric Laparoscopy (GECI). J Pediatr Surg. 2008 Jul. 43(7):1249-53. [Medline].

  2. Fraser JD, Aguayo P, Ho B, et al. Laparoscopic management of intussusception in pediatric patients. J Laparoendosc Adv Surg Tech A. 2009 Aug. 19(4):563-5. [Medline].

  3. Milbrandt K, Sigalet D. Intussusception associated with a Meckel's diverticulum and a duplication cyst. J Pediatr Surg. 2008 Dec. 43(12):e21-3. [Medline].

  4. Soccorso G, Puls F, Richards C, Pringle H, Nour S. A ganglioneuroma of the sigmoid colon presenting as leading point of intussusception in a child: a case report. J Pediatr Surg. 2009 Jan. 44(1):e17-20. [Medline].

  5. Sanni RB, Nandiolo R, Coulibaly Diaoudia MT, Vodi L, Mobiot ML. Acute intussusception due to intestinal Kaposi's sarcoma in an infant. Afr J Paediatr Surg. 2009 Jul-Dec. 6(2):131. [Medline].

  6. Earl TM, Wellen JR, Anderson CD, et al. Small bowel obstruction after pediatric liver transplantation: the unusual is the usual. J Am Coll Surg. 2011 Jan. 212(1):62-7. [Medline].

  7. Bai YZ, Chen H, Wang WL. A special type of postoperative intussusception: ileoileal intussusception after surgical reduction of ileocolic intussusception in infants and children. J Pediatr Surg. 2009 Apr. 44(4):755-8. [Medline].

  8. Turkyilmaz Z, Karabulut R, Gulen S, et al. Role of nitric oxide and cyclooxygenase pathway in lipopolysaccharide-induced intussusception. Pediatr Surg Int. 2004 Aug. 20(8):598-601. [Medline].

  9. Lappalainen S, Ylitalo S, Arola A, Halkosalo A, Räsänen S, Vesikari T. Simultaneous presence of human herpesvirus 6 and adenovirus infections in intestinal intussusception of young children. Acta Paediatr. 2012 Jun. 101(6):663-70. [Medline].

  10. Zanardi LR, Haber P, Mootrey GT, et al. Intussusception among recipients of rotavirus vaccine: reports to the vaccine adverse event reporting system. Pediatrics. 2001 Jun. 107(6):E97. [Medline].

  11. Christie CD, Duncan ND, Thame KA, et al. Pentavalent rotavirus vaccine in developing countries: safety and health care resource utilization. Pediatrics. 2010 Dec. 126(6):e1499-506. [Medline].

  12. Ruiz-Palacios GM, Pérez-Schael I, Velázquez FR, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med. 2006 Jan 5. 354(1):11-22. [Medline].

  13. Contopoulos-Ioannidis DG, Halpern MS, Maldonado Y. Trends in Hospitalizations for Intussusception in California in Relationship to the Introduction of New Rotavirus Vaccines, 1985-2010. Pediatr Infect Dis J. 2015 Jul. 34 (7):712-7. [Medline].

  14. Douglas D. More Intussusception Hospitalizations in California After Rotavirus Vaccine Intro. Reuters Health Information. Available at April 14, 2015; Accessed: June 17, 2015.

  15. Zickafoose JS, Benneyworth BD, Riebschleger MP, Espinosa CM, Davis MM. Hospitalizations for Intussusception Before and After the Reintroduction of Rotavirus Vaccine in the United States. Arch Pediatr Adolesc Med. 2012 Jan 2. [Medline].

  16. Niramis R, Watanatittan S, Kruatrachue A, et al. Management of recurrent intussusception: nonoperative or operative reduction?. J Pediatr Surg. 2010 Nov. 45(11):2175-80. [Medline].

  17. Weihmiller SN, Buonomo C, Bachur R. Risk stratification of children being evaluated for intussusception. Pediatrics. 2011 Feb. 127(2):e296-303. [Medline].

  18. Morrison J, Lucas N, Gravel J. The role of abdominal radiography in the diagnosis of intussusception when interpreted by pediatric emergency physicians. J Pediatr. 2009 Oct. 155(4):556-9. [Medline].

  19. Hooker RL, Hernanz-Schulman M, Yu C, Kan JH. Radiographic evaluation of intussusception: utility of left-side-down decubitus view. Radiology. 2008 Sep. 248(3):987-94. [Medline]. [Full Text].

  20. Tareen F, Mc Laughlin D, Cianci F, Hoare SM, Sweeney B, Mortell A, et al. Abdominal radiography is not necessary in children with intussusception. Pediatr Surg Int. 2016 Jan. 32 (1):89-92. [Medline].

  21. Hryhorczuk AL, Strouse PJ. Validation of US as a first-line diagnostic test for assessment of pediatric ileocolic intussusception. Pediatr Radiol. 2009 Oct. 39(10):1075-9. [Medline].

  22. Munden MM, Bruzzi JF, Coley BD, Munden RF. Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases. AJR Am J Roentgenol. 2007 Jan. 188(1):275-9. [Medline].

  23. Shekherdimian S, Lee SL, Sydorak RM, Applebaum H. Contrast enema for pediatric intussusception: is reflux into the terminal ileum necessary for complete reduction?. J Pediatr Surg. 2009 Jan. 44(1):247-9; discussion 249-50. [Medline].

  24. Jen HC, Shew SB. The impact of hospital type and experience on the operative utilization in pediatric intussusception: a nationwide study. J Pediatr Surg. 2009 Jan. 44(1):241-6. [Medline].

  25. Flaum V, Schneider A, Gomes Ferreira C, Philippe P, Sebastia Sancho C, Lacreuse I, et al. Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control. J Pediatr Surg. 2016 Jan. 51 (1):179-82. [Medline].

  26. Sandler AD, Ein SH, Connolly B, Daneman A, Filler RM. Unsuccessful air-enema reduction of intussusception: is a second attempt worthwhile?. Pediatr Surg Int. 1999. 15(3-4):214-6. [Medline].

  27. Herwig K, Brenkert T, Losek JD. Enema-reduced intussusception management: is hospitalization necessary?. Pediatr Emerg Care. 2009 Feb. 25(2):74-7. [Medline].

  28. Gilmore AW, Reed M, Tenenbein M. Management of childhood intussusception after reduction by enema. Am J Emerg Med. 2010 Oct 25. [Medline].

  29. Hill SJ, Koontz CS, Langness SM, Wulkan ML. Laparoscopic Versus Open Reduction of Intussusception in Children: Experience over a Decade. J Laparoendosc Adv Surg Tech A. 2013 Feb. 23(2):166-9. [Medline].

Abdominal radiograph shows small bowel dilatation and paucity of gas in the right lower and upper quadrants.
Air contrast enema shows intussusception in the cecum.
Barium enema shows intussusception in the descending colon.
CT scan reveals the classic ying-yang sign of an intussusceptum inside an intussuscipiens.
Abdominal ultrasonography reveals the classic target sign of an intussusceptum inside an intussuscipiens.
Laparoscopic view of a jejuno-jejunal intussusception
Note intussusception in the left upper quadrant on this plain film of an infant with pain vomiting. Courtesy of Dr. Kelly Marshall, Children's Healthcare of Atlanta at Scottish Rite.
Intussusception evident during air contrast enema prior to reduction. Courtesy of Dr. Kelly Marshall, Children's Healthcare of Atlanta at Scottish Rite.
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