Pediatric Intussusception

About Intussusception

Intussusception (in-tuh-suh-SEP-shun) is the most common abdominal emergency impacting children under 2 years of ages. It takes place when one part of the bowel moves into the next, much like the pieces of a telescope.

When this “telescoping” happens, the flow of fluids and food through the bowel can end up being blocked, the intestine can swell and bleed, and the blood supply to the affected part of the intestinal tract can get cut off. Ultimately, this can cause part of the bowel to die.

Intussusception occurs in 1 to 4 from every 1,000 babies and is most typical in babies 5 to 9 months old, though older children likewise can have it. Kids get intussusception regularly than women.

Intussusception seen in patients older than age 2-3 years may be related to different medical conditions or situations. The intussusception in these patients is usually small bowel to little bowel; therefore, healing enemas are less handy and are generally not successful.

Signs and Symptoms

Babies and children with intussusception have extreme abdominal pain, which typically starts unexpectedly and causes the child to draw the knees up toward the chest. The pain typically makes the child cry very loudly. As it reduces, the child might stop crying for a while and might seem to feel better. The pain normally reoccurs like this, however can end up being very strong when it returns.

Symptoms also can consist of:

  • abdominal swelling
  • vomiting
  • vomiting up bile, a bitter-tasting yellowish-green fluid
  • passing stools (poop) combined with blood and mucus, referred to as currant jelly stool
  • grunting due to pain

As the health problem continues, the child may slowly end up being weaker. She or he might develop a fever and appear to go into shock, a deadly medical problem where lack of blood flow to the body’s organs causes the heart to beat rapidly and blood pressure to drop.

Some babies with intussusception may just appear drowsy without vomiting, have stool modifications, or have abdominal swelling.

Pediatric Intussusception

Causes

The majority of the time, medical professionals do not know what causes intussusception. Sometimes, it may follow a current attack of gastroenteritis (or “stomach flu”). Bacterial or viral intestinal infections might cause swelling of the infection-fighting lymph tissue that lines the intestinal tract, which might result in one part of the intestine being pulled into the other.

In kids below 3 months of age or older than 5, intussusception is more likely to be brought on by an underlying condition like enlarged lymph nodes, a tumor, or a blood vessel irregularity in the intestines.

Medical diagnosis and Treatment

Medical professionals usually check for intussusception if a child is having repeat episodes of pain, drawing up the legs, vomiting, feeling sleepy, or passing stools with blood and mucous.

During the go to, the doctor will ask about the child’s overall health, household health, any medications the child is taking, and any allergies the child might have. Next, the doctor will take a look at the child, paying unique attention to the abdomen, which may be swollen or tender to the touch. Sometimes the doctor can feel the part of the intestine that’s involved.

If the doctor believes intussusception, the child might be sent to an emergency room (ER). Generally, medical professionals there will ask a pediatric cosmetic surgeon to see the child right away. The ER doctor might order an abdominal ultrasound or X-ray, which can sometimes reveal a clog in the intestines. If the child looks very ill, suggesting damage to the intestinal tract, the surgeon may take the child to the operating room right away to correct the bowel obstruction.

Two kinds of enemas (an air enema or a barium enema) often can diagnose and treat intussusception at the very same time.

For an air enema, a small soft tube is put in the rectum and air is gone through the tube. The flight into the intestinal tracts and describes the bowels on the X-rays. If intussusception is present it reveals the doctors the telescoping piece in the intestine. At the same time, the pressure of the air unfolds the bowel that has been turned within out and cures the clog. Barium, a liquid mix, is sometimes used in location of air to fix the clog in the very same way.

Both types of enema are very safe, and children usually do extremely well. However, it is essential to keep in mind that the intussusception can return in 1 out of 10 cases. This generally takes place within 72 hours following the procedure.

If the intestine is torn, an enema doesn’t work, or the child is too sick to attempt an enema, the child will need surgery. This is frequently the case in older children. Surgeons will try to fix the obstruction, however if too much damage has been done, that part of the bowel will be gotten rid of.

After treatment, the child will stay in the medical facility and get intravenous (IV) feedings through a vein up until she or he can eat and typical bowel function returns. Physicians will watch the child closely to make sure that the intussusception does not return. Some babies may also need antibiotics to avoid infection.

When to Call the Doctor

Intussusception is a medical emergency situation. If you’re stressed that your child has some or all the symptoms of intussusception, such as repeated crampy abdominal pain, vomiting, drowsiness, or death of currant jelly stool, call your doctor or get emergency medical help immediately.

Many babies who are treated within the first 24 Hr recover totally without any problems. However neglected intussusception can cause severe issues that get worse rapidly. So it’s incredibly crucial not to delay treatment– every 2nd counts. Delayed treatment significantly increases the risk of irreparable tissue damage, tearing of the bowel, infection, and potentially death.



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