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intussusception
What are the symptoms of intussusception in children?
Intussusception in children is the most common cause of intestinal obstruction in infants and toddlers, often seen in children aged four to ten months. The main clinical manifestations of pediatric intussusception are paroxysmal abdominal pain. Infants typically exhibit episodes of crying and fussiness, with pale complexion, cyanosis, and frequent vomiting. Prolonged intussusception may result in the passage of bloody stools, resembling jam. In these cases, it is imperative to seek medical attention at a hospital. During a physical examination, doctors can feel an abdominal mass. An abdominal ultrasound can be performed, where a circular mass may be visible, confirming the diagnosis. After diagnosis, pediatric intussusception requires surgical treatment. If the intussusception has not persisted for long, an air enema can be performed. If the intussusception has lasted longer and the general condition is poor, surgical intervention may be needed under aggressive treatment.
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.
Can intestinal intussusception have bowel movements?
After the occurrence of intussusception, the patient's symptoms often manifest as those of intestinal obstruction, causing significant abdominal pain, cessation of gas and stool passage through the anus, and a palpable abdominal mass can be felt. Imaging studies can clearly indicate signs of intussusception. Once intussusception occurs, the patient stops passing stool, and symptoms such as vomiting and nausea also occur. Once diagnosed, it is crucial to treat promptly, including air enema reduction or surgical treatment, to promptly address the symptoms of intussusception, prevent the worsening of intestinal obstruction symptoms, and avoid severe complications such as intestinal necrosis, which can endanger the patient's life.
Intussusception earliest symptoms
The earliest symptoms of intussusception are primarily abdominal symptoms, including mild abdominal distension, abdominal pain, with pain mainly around the navel. This pain generally does not show significant relief and tends to intensify. There may also be cessation of passing gas and stool, and the patient might sometimes experience nausea and vomiting. If the symptoms of intussusception do not alleviate, we carry out an abdominal imaging examination, which may reveal fluid levels, indicating intestinal obstruction, and the intussuscepted bowel can be found. At this point, early air enema reduction can be performed. If the condition is not treated timely, it can lead to aggravated symptoms of intestinal obstruction, and even require surgical treatment.
How to check for intussusception?
Intussusception is primarily diagnosed based on medical history, symptoms, physical signs, and auxiliary examinations. Medical history is mainly gathered by asking the parents, which is very important. Physical signs involve the doctor performing an abdominal palpation, where generally a mass can be felt on the abdominal wall. Auxiliary examinations usually include abdominal ultrasonography and upright abdominal plain films. For more complicated cases or when the location is unique and difficult to detect, a CT scan of the intestines may be performed to make the final diagnosis.
How is intussusception diagnosed?
Intussusception is one of the common acute abdominal conditions in infants and young children. The primary clinical symptoms include abdominal pain, vomiting, and "jam-like" stools, with a mass often palpable in the abdomen. Initially, the overall condition of the child is generally fine, but in the later stages, symptoms such as dehydration, lethargy, coma, and shock can appear. Any healthy infant or young child who suddenly experiences episodic abdominal pain or periodic, regular bouts of crying, accompanied by vomiting, bloody stools, and a sausage-shaped mass in the abdomen, should be highly suspected of having intussusception. Once intussusception is confirmed, timely enema treatment should be administered to the child, and if the opportunity for an enema has passed, surgical treatment should be considered.
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.
How long will diarrhea from intussusception take to get better?
Intussusception causes diarrhea. In such cases, the intussusception itself indicates an intestinal blockage. Patients with the obstruction will experience significant pain, vomiting, bloating, and closure. The anus will stop discharging gas or stool. If diarrhea occurs at this time, it is not caused by the intussusception. If the intussusception cannot be resolved, the diarrhea will improve in the short term. Of course, we must address the main issue of intussusception, and the diarrhea can be temporarily disregarded. We only need to perform air enema reduction and mainly resolve the intestinal obstruction and intussusception through surgical treatment. Diarrhea, because it is treated with IV fluids and some intestinal anti-inflammatory medications, will naturally subside.