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Hu Qi Feng
Pediatrics
About me
Since graduating in 2003, I have been working in pediatric clinical practice and have extensive experience in this field. In 2012, I completed a training program in the Pediatric Intensive Care Unit (PICU) at the Children's Hospital in Hunan Province, focusing on respiratory management and mechanical ventilation for critically ill children, as well as the treatment of septic shock.
Proficient in diseases
Specializing in pediatric critical care, dedicated to rescuing and treating children with critical conditions such as respiratory failure, heart failure, shock, poisoning, etc., and has been involved in the treatment of severe cases of hand, foot, and mouth disease multiple times.
Voices
Can children with intussusception drink water?
Intussusception can cause symptoms such as abdominal pain and vomiting. When intussusception has not been reduced, it is not recommended to drink water or eat food, because the vomit can lead to choking. It can also cause vomit to enter the trachea, leading to aspiration pneumonia, suffocation, and other serious symptoms. Therefore, generally after the intussusception is reduced and there is anal exhaust, proving that the intestines are unobstructed, then drinking water is permitted.
The earliest symptoms of intussusception in infants
The early symptoms of infantile intussusception mainly include abdominal pain and vomiting. The abdominal pain is typically paroxysmal and severe, manifesting as acute, intermittent colic. The child may cry and be restless, curling up with knees drawn in, and may appear pale. The abdominal pain eases after several minutes or more, but reoccurs every ten to twenty minutes. Vomiting mainly involves reflexive vomiting of curdled milk or food residues. In later stages, bile and fecal-like liquid may be present, indicating intestinal obstruction.
Infant Intussusception Symptoms and Treatment
Clinical manifestations of intussusception include: firstly, abdominal pain, which is paroxysmal, regular, and characterized by sudden episodes of colicky pain. The child may cry, appear restless, draw knees to the abdomen, have a pale face, and experience pain that lasts for several minutes or longer. The pain subsides, and the child may fall asleep quietly, but the pain typically recurs at intervals of ten to twenty minutes. Secondly, vomiting is an early symptom, initially reflexive and containing curds and food residue, later possibly including bile. Thirdly, bloody stools are an important symptom, with about 85% of cases passing jelly-like mucoid bloody stools within six to twelve hours after onset. Fourthly, an abdominal mass is often located in the upper right abdomen below the costal margin, where a slightly prominent intussusception mass can be felt. In terms of systemic symptoms, the general condition is good in the early stages, with no symptoms of systemic poisoning. As the disease progresses, the condition worsens, and complications such as intestinal necrosis or peritonitis may develop, leading to deterioration of systemic symptoms and possibly resulting in dehydration, high fever, coma, shock, and other toxic symptoms. Treatment methods include both surgical and non-surgical treatments.
Can infantile intussusception heal by itself?
Once intestinal intussusception occurs, only a small portion of small bowel intussusception can reduce spontaneously, becoming temporary small bowel intussusception, while intussusception involving the colon or repeated intussusception generally cannot reduce on its own. Due to the continuous spasm of the sheathed intestine, circulatory disturbances occur in the intussuscepted segment, initially impeding venous return, causing tissue congestion and edema, varicose veins, and mucous cells secreting large amounts of mucus into the intestinal lumen. This results in a jam-like gelatinous discharge mixed with blood and fecal matter. The bowel wall swells, worsening the obstruction of venous return, affecting the arteries, leading to insufficient blood supply, causing necrosis of the intestinal wall, and systemic toxicity symptoms. In severe cases, this can lead to intestinal perforation and peritonitis. Treatment generally involves air or barium enema or surgical methods.
Can pediatric intussusception be cured?
Once intussusception occurs, only a small portion of the small intestinal intussusception can reduce on its own. Those occurring in the colon or where re-intussusception occurs generally cannot reduce spontaneously and require enema therapy or surgical treatment. Enema therapy refers to cases where the intussusception occurs within forty-eight hours, the overall condition is good, there is no abdominal distension, no obvious dehydration or electrolyte disorders, and air or barium enema can be used. If the condition persists for more than forty-eight hours, the overall condition is poor, with symptoms such as dehydration, lethargy, high fever, shock, significant abdominal distension, signs of peritoneal irritation, multiple occurrences of intussusception, prior organic changes, or situations requiring surgical treatment for small bowel intussusception.
Symptoms of recurrent intussusception in children
5-8% of the children may experience recurrent intussusception. Enema reduction has a higher recurrence rate than surgical reduction. The manifestations of recurrence are similar to the initial episode, primarily presenting as abdominal pain, vomiting, bloody stools, or a palpable intussusceptum-like mass in the abdomen. The abdominal pain is mainly intermittent, and can last for several minutes or longer, accompanied by pale complexion. The vomitus may include curds or food residues, possibly containing bile; in later stages, it may resemble fecal matter. Bloody stools may appear as jelly-like mucoid blood.
Does infant intussusception require surgery?
Intussusception lasting between forty-eight and seventy-two hours, or if the duration is shorter but the condition is severe, including cases with intestinal necrosis or perforation, as well as those involving small intestine type intussusception, all require surgical treatment. Depending on the overall condition of the child and the pathological changes in the intussuscepted bowel, options include reduction of intussusception, intestinal resection and anastomosis, or enterostomy, etc.
Typical symptoms of intussusception in children
The typical symptoms of intussusception include abdominal pain, which initially presents as sudden, severe, crampy pain. The affected child may cry, appear restless, draw their knees up to their stomach, and have a pale complexion. The pain may last several minutes or longer and then relieve, with repetitions every ten to twenty minutes. The second symptom is vomiting, which is an early symptom that initially may include curdled milk and food residues, and later may contain bile or fecal matter. The third symptom is bloody stools, where approximately 85% of affected children may pass jelly-like mucus and blood within six to twelve hours of onset. An abdominal mass is often found in the upper right abdomen, and a sausage-shaped mass that is slightly movable upon touch can be felt beneath the ribs. Regarding the overall condition of the child, they may be able to attend school in the early stages without showing signs of toxicity. As the condition progresses, complications such as bowel necrosis or peritonitis can develop, leading to worsening systemic symptoms, including severe dehydration, high fever, drowsiness, coma, or shock.
How is intussusception in infants caused?
Intussusception is divided into primary and secondary types, with 95% being primary, commonly seen in infants. This is due to the fact that the mesentery at the ileocecal region in infants is not fully fixed and has greater mobility, which are structural factors that facilitate intussusception. For the 5% of secondary cases, these are more common in older children, whose intestines often have clear organic causes for intussusception. These causes include the inversion of a Meckel's diverticulum into the ileal lumen serving as a lead point; intestinal polyps, intestinal tumors, intestinal duplications, and abdominal purpura can cause thickening and swelling of the bowel wall leading to intussusception. Additionally, certain facilitating factors can disrupt the rhythm of intestinal peristalsis, thereby inducing intussusception. Changes in diet, viral infections, and diarrhea are among the factors that can trigger intussusception.
Caused by infantile intussusception
Intussusception is divided into primary and secondary types, with 95% being primary cases, most commonly seen in infants and young children. This is due to the fact that the mesentery of the ileocecal part in infants and young children is not yet fully fixed and has a greater degree of mobility, which are structural factors that facilitate the occurrence of intussusception. The remaining 5% are secondary cases generally occurring in older children, where the affected intestines often have a clear organic cause, such as a Meckel's diverticulum turning into the ileal lumen, serving as the starting point for intussusception. Other causes like intestinal polyps, tumors, duplications, or abdominal purpura can cause the intestinal wall to swell and thicken, which can also trigger intussusception.