Related Experiment Video
Updated: Apr 1, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Severe colic mimicking intussusception: a new phenomenon
1Division of Paediatric Surgery, Department of Surgery, Burjeel Hospital , Abu Dhabi , UAE.
Insights
Severe abdominal pain in children can be caused by fecal impaction, not intussusception. Early recognition of this condition prevents unnecessary medical interventions and surgeries.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Abdominal Pain Management
Background:
- A novel phenomenon of severe abdominal colic in children has been observed over the past five years.
- Patients present with a distinct clinical picture of sudden, acute, severe abdominal colic accompanied by continuous screaming for 1-2 minutes.
Purpose of the Study:
- To describe and highlight a newly identified cause of severe abdominal pain in pediatric patients.
- To differentiate this condition from acute intussusception, which is the initial clinical and ultrasonographic diagnosis.
Main Methods:
- A retrospective study of 11 children aged 9 months to 5 years presenting with acute severe abdominal colic between 2009 and 2014.
- Review of clinical data, ultrasonography (US), abdominal X-rays, and diagnostic gastrografin enemas.
Main Results:
- Initial diagnosis in all cases was intussusception, supported by US findings mimicking the condition.
- Radiological evaluation revealed fecal impaction of the terminal ileum and cecum as the underlying cause.
- Diagnostic enemas excluded intussusception and confirmed fecal impaction, with a significant response to enema treatment.
Conclusions:
- Severe abdominal pain in children can be attributed to fecal impaction of the terminal ileum and cecum, a phenomenon requiring increased clinical awareness.
- Recognizing this condition can prevent misdiagnosis, unnecessary investigations, and potentially harmful surgical exploration.
Objective:
To highlight a new phenomenon that we have encountered in children during the past 5 years. Children in this group have a pathognomonic clinical picture of sudden acute severe abdominal colic during which the child is continuously screaming for 1-2 min. All these patients were initially diagnosed on clinical and ultrasonographic grounds as acute intussusception. Careful interpretation of the radiological findings revealed faecal impaction of the terminal ileum and caecum.
Design:
This is a retrospective study looking at children presenting between 2009 and 2014 with acute severe abdominal colic pain. These were 11 patients aged 9 months to 5 years. We reviewed our experience in the management and diagnosis of these patients.
Result:
All patients were diagnosed initially as intussusception, which was confirmed by ultrasonography (US). US revealed an appearance mimicking intussusception, 3 cases of which were intermittent. This US appearance proved to be a hard stool filling the terminal ileum. In all patients, abdominal X-ray revealed stool at the right side of the colon filling the caecum. Diagnostic gastrografin enemas that were performed in four patients excluded intussusception and confirmed stool at the caecum and ascending colon. In none of those patients had contrast passed into the terminal ileum. There was dramatic response to fleet and/or gastrografin enemas. Five patients required a second dose of enema and two patients required three doses.
Conclusions:
We highlight a new phenomenon of severe abdominal pain caused by faecal impaction of the terminal ileum and caecum. Increased awareness of this condition helps to avoid unnecessary investigations and/or surgical exploration.
Related Concept Videos
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:23Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are: