How is the removal of the intussusception under the bright X-ray in children?

This is an automatically translated article.

The article is expertly consulted by Master, Doctor Nguyen Hong Hai - Doctor of Radiology - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital. The doctor has many years of experience in the field of diagnostic imaging.
Once detected, intussusception should be monitored and treated immediately. Under-intussusception with enhanced radiographs is a commonly used method of intussusception in children with higher efficiency when compared with adult intussusception, this method is less invasive and limits the intervention of patients. surgery on a child.

1. Overview of intussusception

Intussusception is a disease in which one segment of intestine slides into the lumen of another adjacent bowel. Intussusception interferes with the circulation of digestive juices and circulation to the intestine, leading to intestinal perforation, infection, and necrosis. Intussusception is the most common intestinal obstruction in children under 3 years of age, mainly in children aged 6 months to 2 years. Intussusception usually occurs with ileocecal intussusception.
The cause of intussusception in children is in most cases unknown. The typical setting of childhood intussusception is that it occurs in healthy children with sudden abdominal pain and crying. Abdominal pain usually occurs in episodes, each about 15 to 20 minutes apart. The child may be in a position where the legs are bent to the chest to relieve pain. Some other clinical manifestations may be bloody, bloody stools, vomiting, palpable abdominal mass, fever. In children, intussusception under enhanced radiographs is an effective treatment.

2. Indications/Contraindications to intussusception under bright X-ray in which cases?

Intussusception under enhanced radiographs is a capable means of both diagnosing and treating intussusception. A solution or gas is injected into the intestine through a small catheter placed in the rectum. This maneuver creates pressure just strong enough to remove the intussusception and release the two intussusception segments. The selected solution contains contrast agent that will coat the intestinal lumen and give a clear picture of the structure and abnormalities of the intestine.
Intussusception under bright X-ray is indicated in the following cases:
Intussusception occurs in children, with priority given to children younger than 3 months old and children over 5 years old. Intussusception in children is more effective than in adults. Intestinal progression lasting more than 48 hours The child has clinical manifestations of bloody mucus stools Suspected complications of small bowel obstruction. Intussusception under bright X-ray is only effective for early intussusception in children without complications. Contraindications to intussusception under bright x-ray include:
Patients with severe dehydration Suspected serious complications such as peritonitis, sepsis, shock. These cases are emergency situations, patients need to be prioritized to perform surgery to ensure life safety. The patient is in poor condition, has underlying medical conditions such as chronic medical disease.

3. What does the patient need to prepare before the procedure?

Before performing an intussusception under enhanced X-ray, the patient should note the following requirements:
Fasting and fasting before the procedure for at least 6 hours Enema clean the intestines before entering the intubation room. intestine. This step is performed by the patient's family member or medical staff. Listen to the medical staff explain the procedure and steps to perform intussusception. Need to stay calm, don't worry. In case the patient is overstimulated and uncooperative, the doctor may consider prescribing additional sedatives. It is necessary to bring medical records and relevant documents for verification before starting the procedure.

4. Procedure for performing intussusception under bright X-ray

Performing an intussusception under an enhanced X-ray involves the following steps:
Prepare equipment including X-ray machine, protective equipment such as lead vest and X-ray prevention devices. Prepare medicine and medical supplies. including contrast agents, tranquilizers, anesthetics if indicated, physiological saline, lubricating paraffin, enemas, syringes of all kinds, gloves, ... Examine the patient carefully before Perform intubation to rule out contraindications. After the enema is clean, lubricate and insert a catheter into the rectum. Connect the rectal catheter to the medication or air pump system. Inject the contrast agent or inflate slowly. Follow the image of the intussusception under the magnifying screen until the intussusception is completely removed. Pay attention to the pressure level displayed. When the pressure rises to a high level but the bunion has not been removed, it should be stopped and other treatment options such as surgery should be considered. After removal, it is necessary to take an X-ray film to check, make sure there is no air in the abdomen to rule out complications of intestinal perforation due to intubation. Vinmec International General Hospital with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in medical examination and treatment, patients can rest assured to visit. and hospital treatment.

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