Intussusception (in-tuh-suh-SEP-shun) is the most typical abdominal emergency situation impacting children under 2 years old. It takes place when one portion of the bowel moves into the next, just like the pieces of a telescope.
When this “telescoping” happens, the flow of fluids and food through the bowel can become obstructed, the intestinal tract can swell and bleed, and the blood supply to the affected part of the intestine can get cut off. Eventually, 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 also can have it. Young boys get intussusception more often than women.
In the huge bulk of cases of intussusception in children, the cause is unidentified. Because intussusception appears to take place more frequently in the fall and winter season and since numerous children with the issue also have flu-like symptoms, some think a virus may contribute in the condition. Often, a lead point can be recognized as the cause of the condition– most regularly the lead point is a Meckel’s diverticulum (a pouch in the lining of the small intestine).
Symptoms and signs
Babies and children with intussusception have intense abdominal pain, which frequently begins unexpectedly and causes the child to draw the knees up toward the chest. The pain often makes the child cry really loudly. As it eases, the child may stop weeping 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 likewise can consist of:
- abdominal swelling
- vomiting up bile, a bitter-tasting yellowish-green fluid
- passing stools (poop) blended with blood and mucus, known as currant jelly stool
- grunting due to pain
As the illness continues, the child might slowly end up being weaker. He or she may develop a fever and appear to enter into shock, a deadly medical issue in which lack of blood flow to the body’s organs causes the heart to beat quickly and high blood pressure to drop.
Some babies with intussusception may just appear drowsy without vomiting, have stool changes, or have abdominal swelling.
The majority of the time, physicians do not know what causes intussusception. Sometimes, it might follow a recent attack of gastroenteritis (or “stomach flu”). Bacterial or viral intestinal infections may cause swelling of the infection-fighting lymph tissue that lines the intestinal tract, which may 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 caused by an underlying condition like bigger lymph nodes, a tumor, or a blood vessel irregularity in the intestines.
Medical diagnosis and Treatment
Doctors typically look 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 inquire 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 special attention to the abdomen, which may be swollen or tender to the touch. Often 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). Usually, physicians there will ask a pediatric cosmetic surgeon to see the child immediately. The ER doctor may purchase an abdominal ultrasound or X-ray, which can often show an obstruction in the intestines. If the child looks really ill, suggesting damage to the intestine, the cosmetic surgeon may take the child to the operating room right now to remedy the bowel obstruction.
Two kinds of enemas (an air enema or a barium enema) often can detect and treat intussusception at the exact same time.
For an air enema, a small soft tube is put in the anus and air is gone through television. The flight into the intestinal tracts and outlines the bowels on the X-rays. If intussusception exists it shows the medical professionals the telescoping piece in the intestine. At the same time, the pressure of the air unfolds the bowel that has been turned inside out and remedies the clog. Barium, a liquid mix, is in some cases used in location of air to repair the blockage in the same method.
Both types of enema are extremely safe, and children usually do extremely well. Nevertheless, it’s important to keep in mind that the intussusception can return in 1 out of 10 cases. This normally happens within 72 hours following the procedure.
If the intestinal tract is torn, an enema does not work, or the child is too ill to try an enema, the child will require surgery. This is frequently the case in older children. Surgeons will aim to fix the obstruction, but if too much damage has actually been done, that part of the bowel will be eliminated.
After treatment, the child will stay in the hospital and get intravenous (IV) feedings through a vein until she or he can eat and typical bowel function returns. Medical professionals will view the child carefully to make sure that the intussusception does not return. Some babies may also need antibiotics to prevent 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, sleepiness, or passing of currant jelly stool, call your doctor or get emergency medical assistance immediately.
A lot of infants who are dealt with within the first 24 hours recover completely without any problems. However untreated intussusception can cause severe issues that worsen quickly. So it’s incredibly essential not to delay treatment– every 2nd counts. Delayed treatment significantly increases the risk of irreparable tissue damage, tearing of the bowel, infection, and possibly death.
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