Intussusception in children: Urgent urgent need

This is an automatically translated article.

The article was professionally consulted with Specialist Doctor II Tran Van Trong - Department of General Surgery - Vinmec International Hospital Da Nang.

1. What is intussusception?

Intussusception is a serious disease involving the intestinal tract, which includes the small intestine and large intestine. This is when the upper intestine moves and enters the lumen of the lower intestine, blocking the flow of the intestine. When the intestines interlock, blood vessels are also involved. As a result, the intestinal blood vessels are constricted, damaged, causing bleeding. If not treated promptly, the intussusception will become necrotic, leading to intestinal perforation and abdominal infection.
In very rare cases, the intussusception can be removed on its own (usually small bowel intussusception) without treatment. However, this condition must be determined and monitored by a doctor, and relatives must not arbitrarily wait for the cage block to remove itself.

2. Causes of intussusception

The reason why infants often develop intussusception is still unknown. However, intussusception is not related to children running, jumping, playing as many people mistakenly believe and there are a number of factors that increase the risk of intussusception recorded as follows:
Intussusception often occurs in children chubby, previous respiratory and intestinal viral infections... Age: Intussusception can occur at any age, but statistics show that up to 80-90% of cases of intussusception are children under 1 year old. In which, the age of most intussusception is children 5-9 months old. Many theories suggest that this is the period when the baby changes from milk to solid food, so the intestines are prone to abnormal contractions leading to intussusception. In addition, because the development of the small intestine and large intestine in children at this time has too much difference in size, it is also easy to lead to the phenomenon of intestinal intussusception. Gender: Intussusception occurs more often in boys. Unusual problems: inflammatory bowel disease, intestinal tumor, intestinal polyps or disease causing intestinal contractility disorder, immunodeficiency syndrome .

3. Symptoms of intussusception

Abdominal pain: children have symptoms of intermittent abdominal pain, sudden, intense crying, children hunched over, twisting, ... Colic pain can make children stop playing, stop feeding. Vomiting: In the early stages of intussusception, the child vomits food. In the late stages, children may vomit green or yellow fluid. Blood in the stool: often appears in the late stage, the child may have red or brown blood in the stool, and the stools have pink mucus. For children who are having fever, cough, viral infection or those who have had intussusception, the symptom of sudden crying intermittently is also a suspicious sign of intussusception. Other symptoms: tired child, pale skin, dry lips, fast pulse, cold body, sunken eyes, fever, dehydration,...

4. How to manage intussusception in children

Because intussusception in children progresses very quickly, as soon as the child shows signs of crying, refusing to breastfeed and vomiting a lot, parents need to take the child to the emergency room. Doctors will determine the disease through examination, ultrasound, intestinal X-ray, CT scan.
After determining the child has intussusception, the child will be treated with air intubation. Vinmec International General Hospital has successfully performed air intubation with modern equipment from diagnosis to treatment. The procedure is performed as follows: Place a small catheter into the rectal lumen. Under the guidance of a local X-ray machine, the doctor will slowly inflate the large intestine with appropriate pressure until the interlocking bowel mass is completely removed. If the child is brought to the hospital too late (after 24 hours of intussusception), laparoscopic surgery is often required to remove the intussusception.
Indications for laparoscopic intussusception:
When air intubation fails. Patient arrived late after 24 hours. However, depending on the condition of the intussusception and the experience of the doctor, there are still some children with intussusception that are late after 24 hours can still be removed by air without surgery. Repeated intussusception (>2 times) with uncertain etiology (laparoscopic intubation combined with diagnosis). In case the parents bring the child to be more than 24 hours late, the intussusception has penetrated deeply, causing swelling, blood vessel blockage or even necrosis, the doctors will have to operate to remove the affected intestine. this cage. However, the care and resuscitation after surgery is also very difficult and complicated, children easily die from exhaustion and severe pneumonia. Therefore, the advice for parents is to take the child to a major hospital as soon as the baby shows signs of suspected intussusception.

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