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intussusception
Intussusception should visit which department?
Intussusception generally falls under pediatric surgery, but many children arrive at the hospital without a clear self-diagnosis of intussusception; they often come due to abdominal pain. They can visit either the internal medicine department or the surgical department. At this point, the attending physician will conduct a thorough medical history inquiry, such as a standing abdominal radiograph, abdominal ultrasonography, and physical examination, to aid in diagnosis. If a diagnosis confirms the need for surgical intervention, whether it involves air enema or surgery, it is definitely within the scope of the surgical department.
Can intussusception in the elderly be cured?
Intussusception in the elderly rarely heals on its own, and the likelihood of recovery without treatment is very small. This is because the causes of intestinal issues in the elderly are primarily benign, often due to cirrhosis or other reasons. Furthermore, intussusception may also occur due to tumors, which generally require surgical treatment. It is advised that if diagnosed with intussusception, it is best to undergo surgical treatment at a hospital to prevent recurrence. If it is due to a tumor, there is a risk of it becoming malignant and metastasizing.
How to treat intussusception in children?
Intussusception in children is a common surgical condition. The treatment approach depends on the severity of the child's clinical symptoms. If the intestines have not been telescoped for long, and the intestinal mucosa has not suffered ischemic necrosis, and if the clinical symptoms are mild, air enema can be used to relieve the intussusception without the need for surgery. However, if the clinical symptoms are severe and necrosis has been prolonged, meaning the intestinal mucosa has reached a state of ischemia and necrosis that is irreparable, surgical treatment in a surgical setting is definitely required. Whether surgery or air enema is needed should be decided based on the actual color ultrasound results and a comprehensive diagnosis by the clinician.
Early symptoms of intussusception in children
Intussusception in children refers to a segment of the intestine telescoping into the adjoining lumen, causing an obstruction to the passage of intestinal contents. Intussusception accounts for 15%-20% of intestinal obstructions and can be primary or secondary. Generally, primary intussusception is more common in infants and young children. Early symptoms may include bloating, abdominal pain, vomiting, possibly accompanied by bloody stools, and a palpable mass in the abdomen. Moreover, intussusception can occur in multiple locations, such as jejunum into jejunum, jejunum into ileum, ileum into ileum, ileum into cecum, ileum into colon, colon into colon, etc. Among these, ileo-cecal intussusception is the most common, while small intestine into small intestine and colon into colon are relatively rare.
Does intussusception cause diarrhea?
Intussusception is a common surgical condition in infants and young children, characterized primarily by symptoms such as abdominal pain, crying, abdominal distension, the passage of jelly-like stools, and vomiting. Some children may also experience diarrhea and frequent passage of jelly-like stools, where the symptoms of intussusception may not be particularly noticeable, leading parents to possibly overlook them. Therefore, if a child has diarrhea accompanied by jelly-like stools, it is crucial to take the child to the hospital for a consultation and an ultrasound to confirm whether it is caused by intussusception. If left untreated for a long time, it can lead to ischemic necrosis of the intestinal mucosa, necessitating surgical treatment.
Causes of Intussusception in the Elderly
Intussusception refers to an obstruction caused by one segment of the intestine entering an adjacent segment, which can occur at any age. In adults, over 85% of intussusception cases can be attributed to organic lesions, typically tumors, but also possibly due to polyps or diverticula in the intestines. Typical symptoms of intussusception may include abdominal pain, an abdominal mass, and jelly-like bloody stool. In adults, intussusception is generally treated surgically. The surgical approach often involves exploratory laparotomy, possibly involving intestinal resection and anastomosis. For the resected part, reinforced suturing is usually required. If a primary anastomosis cannot be tolerated, procedures such as creating a stoma or exteriorizing the intestine may be performed, awaiting stabilization of the condition before further treatment.
Intussusception: How to Diagnose
Intussusception is one of the most common acute abdominal conditions in infants and toddlers, primarily seen in children under one year old. It refers to the condition where part of the intestine and its mesentery slip into an adjacent intestinal lumen, causing obstruction at the root of the intestine. The diagnosis of intussusception in children is mainly based on clinical symptoms. A previously healthy child may suddenly experience an episode of severe, regular, intermittent colicky pain. The child may appear restless, crying, with knees bent, a reduced amplitude of movement, and a pale complexion, with the abdominal pain easing after 10 to 20 minutes. The child may also vomit and pass bloody stools. Bloody stools are a very important symptom; approximately 85% of cases will pass jelly-like, mucousy bloody stools within 6 to 12 hours of onset, or even if there is no bloody stool visible, rectal examination can reveal its presence. A sausage-shaped mass can be felt in the abdomen. Furthermore, an ultrasound can show a typical image of a concentric circle or target-sign mass. Under ultrasound monitoring, procedures such as air or hydrostatic enema can be performed, which help in the early diagnosis of intussusception.
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.
What tests need to be done for intussusception?
Intussusception is a common surgical disease in infants and young children, characterized clinically by crying, abdominal pain, abdominal distention, the passage of jelly-like stools, and vomiting. Auxiliary examinations for this condition primarily involve abdominal ultrasonography, though occasionally an abdominal X-ray can be performed. If a child experiences intussusception, treatment can vary depending on the severity; mild cases might be treated with an air enema. However, if the symptoms of intussusception are severe and prolonged, leading to ischemic necrosis of the intestines, surgical intervention is definitely required. In summary, the examination for intussusception primarily involves abdominal ultrasonography.
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.