Infant intussusception symptoms

Written by Hu Qi Feng
Pediatrics
Updated on September 01, 2024
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Intussusception clinically presents with abdominal pain, which occurs in fits and starts and has a regular pattern. This manifests as sudden spasmodic colic; the child cries and is restless, drawing the knees up to the belly and turning pale. The pain lasts for several minutes or longer, then eases off, allowing the child to fall asleep quietly. These episodes recur every 10 to 20 minutes as intestinal movements provoke further attacks. Vomiting occurs, initially consisting of curdled milk or food residues and later containing bile-stained, feculent fluid. Moreover, blood in stools is an important symptom. Symptomatically, stools may appear normal for a few hours, but within six to twelve hours, 85% of affected children might pass jelly-like mucus blood stools. A palpable lump can be detected in the upper right abdomen, indicative of the point of intussusception. As for general symptoms, the child may appear well early on, but as the condition worsens, intestinal necrosis or peritonitis may occur, leading to severe dehydration, high fever, lethargy, coma, shock, and other signs of systemic toxicity.

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Written by Hu Qi Feng
Pediatrics
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Does intussusception require a CT scan?

Intussusception is commonly diagnosed through routine abdominal ultrasound examinations, which have a positive rate of over 90%. In the ultrasound, the transverse section of the intussusception can show concentric circles or target ring-shaped mass images, and the longitudinal section may reveal the sleeve sign. Additionally, a barium enema can be employed, along with X-ray imaging. Under X-ray, the lead point of intussusception appears as a mass shadow, and air enema reduction treatment can be performed concurrently. Generally, CT is not used as a routine diagnostic tool.

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Written by Hu Qi Feng
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Infant intussusception typical symptoms

The typical clinical manifestations of intussusception are as follows: Firstly, abdominal pain, which occurs in paroxysmal, regular episodes, characterized by sudden onset of severe colicky pain. The child appears restless and cries, with knees drawn to the abdomen, pale complexion, and relief coming after several minutes or longer; the pain reoccurs every ten to twenty minutes. Secondly, vomiting is an early symptom, initially reflexive containing milk curds or food residues, later possibly containing bile, and in the late stage, fecal-like liquid may be vomited. Thirdly, bloody stools are a significant symptom, appearing within the first few hours; initially, stools may appear normal, later becoming scanty or absent. In about 85% of cases, a jam-like mucousy bloody stool is passed within six to twelve hours of onset, or bloody stools are found upon rectal examination. Fourthly, abdominal mass is often found in the right upper quadrant just below the ribs, where a slight movable intussusception mass can be palpated, resembling a sausage.

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Written by Yao Li Qin
Pediatrics
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Pediatric intussusception should see which department?

Pediatric intussusception is a surgical condition, so it is of course treated by pediatric surgery. When a child shows persistent crying and abdominal pain, along with bloody stools, there is a high suspicion of intussusception, and they should see a pediatric surgeon. A professional pediatric surgeon will conduct a comprehensive physical examination of the child. If intussusception is suspected, an air enema should be performed under the guidance of X-ray imaging. Once intussusception is confirmed, conservative treatment is initially attempted. If conservative treatment fails, surgical treatment is required. Therefore, based on the above, pediatric intussusception definitely requires consultation with pediatric surgery.

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Written by Hu Qi Feng
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Causes of intussusception in children

The etiology of intussusception is divided into primary and secondary types, with 95% being primary, which is common in infants and young children. In infants, the mesentery of the ileocecal region is not yet fully fixed and has a larger degree of mobility, which is a structural factor conducive to the occurrence of intussusception. Secondary cases account for about 5%, often secondary to Meckel's diverticulum, intestinal polyps, intestinal tumors, intestinal duplications, and abdominal purpura causing swelling and thickening of the intestinal wall, which can lead to intussusception. Certain factors may cause a change in the rhythmic movement of the intestines leading to disorder, thereby inducing intussusception, such as changes in diet, viral infections, and diarrhea.

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Written by Quan Xiang Mei
Pediatrics
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Is intestinal intussusception easy to treat?

Intussusception is a common pediatric surgical condition in infancy and early childhood. It is characterized clinically by abdominal distension, abdominal pain, and the passage of jelly-like stools. Mild cases of intussusception can usually be treated in a clinical setting with an air enema under surgical guidance. However, severe intussusception, which has led to ischemia or necrosis of the intestinal mucosa, must be treated surgically. Therefore, the treatment of intussusception is not difficult, but it is crucial to avoid misdiagnosis. With timely diagnosis, the condition is relatively easy to manage with the best and most appropriate treatment, where diagnosis is the most critical aspect.