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intussusception
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.
Can intussusception pass gas?
Intussusception should be considered when the patient shows symptoms of intestinal obstruction, namely pain, vomiting, distension, and paralysis, along with cessation of gas and stool passing through the anus. In the early stages of intussusception, there may be a small amount of gas and stool passage, but the presence of intussusception should not be overlooked, and imaging studies can be performed for confirmation. If there is a fluid level in the intestinal lumen and clear signs of intestinal obstruction, and if the patient can feel a distinct mass in the abdomen, which on imaging shows concentric ring-like changes, intussusception should be considered. Once diagnosed, timely treatment is essential, thus treatment should not be delayed until there is an absence of stool and gas passage.
Typical symptoms of intussusception in children
The typical symptoms of intussusception include abdominal pain, which initially presents as sudden, severe, crampy pain. The affected child may cry, appear restless, draw their knees up to their stomach, and have a pale complexion. The pain may last several minutes or longer and then relieve, with repetitions every ten to twenty minutes. The second symptom is vomiting, which is an early symptom that initially may include curdled milk and food residues, and later may contain bile or fecal matter. The third symptom is bloody stools, where approximately 85% of affected children may pass jelly-like mucus and blood within six to twelve hours of onset. An abdominal mass is often found in the upper right abdomen, and a sausage-shaped mass that is slightly movable upon touch can be felt beneath the ribs. Regarding the overall condition of the child, they may be able to attend school in the early stages without showing signs of toxicity. As the condition progresses, complications such as bowel necrosis or peritonitis can develop, leading to worsening systemic symptoms, including severe dehydration, high fever, drowsiness, coma, or shock.
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.