intussusception

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Written by Hu Qi Feng
Pediatrics
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Caused by infantile intussusception

Intussusception is divided into primary and secondary types, with 95% being primary cases, most commonly seen in infants and young children. This is due to the fact that the mesentery of the ileocecal part in infants and young children is not yet fully fixed and has a greater degree of mobility, which are structural factors that facilitate the occurrence of intussusception. The remaining 5% are secondary cases generally occurring in older children, where the affected intestines often have a clear organic cause, such as a Meckel's diverticulum turning into the ileal lumen, serving as the starting point for intussusception. Other causes like intestinal polyps, tumors, duplications, or abdominal purpura can cause the intestinal wall to swell and thicken, which can also trigger intussusception.

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Written by Li Chang Yue
General Surgery
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Can you drink water with intussusception?

Patients with intestinal intussusception should avoid drinking water as much as possible. Once intussusception occurs, it can lead to a complete intestinal obstruction. Drinking water at this time can easily increase the burden on the intestines, causing nausea, vomiting, abdominal distension, and a series of other problems. For patients with intestinal intussusception, an emergency intestinal barium air pressure procedure can be performed to reposition the intestines. If this fails, surgical treatment should be pursued actively. Currently, patients with intussusception can be treated with traditional open surgery to release the intussusception, or using laparoscopic interventions to resolve it. Both types of surgery are very effective in treating intussusception and typically have satisfactory outcomes.

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Written by Hu Qi Feng
Pediatrics
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Is infant intussusception dangerous?

Intussusception is a life-threatening emergency, and its reduction is an urgent treatment measure that should be performed immediately once confirmed. It is a common acute abdomen disease in infants and young children. Initially, the general condition may be good, but as the disease progresses, the condition worsens, leading to systemic deterioration, complications such as intestinal necrosis or peritonitis, and severe symptoms of poisoning such as severe dehydration, high fever, lethargy, coma, and shock.

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Written by Hu Qi Feng
Pediatrics
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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 Hu Qi Feng
Pediatrics
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Pediatric intussusception should see which department?

Intussusception often occurs in infants and young children, so the main symptoms are vomiting, bloody stools, and abdominal pain. Therefore, the initial consultation is usually in pediatric emergency. When intussusception is suspected as a cause of acute abdomen, the doctor will conduct intestinal tube and abdominal ultrasound examinations. If the ultrasound confirms intussusception, a transfer to pediatric surgery or emergency surgery may be considered for appropriate surgical treatment. Thus, the initial choice for consultation is usually pediatrics, but after a diagnosis is confirmed, treatment should be transferred to pediatric surgery.

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Written by Hu Qi Feng
Pediatrics
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Can intussusception in children cause fever?

In the early stages of intussusception, the child generally remains in good condition, with normal body temperature and no symptoms of systemic poisoning. As the disease progresses and worsens, complications such as intestinal necrosis or peritonitis may develop, leading to deterioration of the overall condition. At this point, severe dehydration, high fever, lethargy, coma, and shock, among other symptoms of poisoning, can occur. Therefore, fever can indeed appear in the later stages of intussusception.

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Written by Hu Qi Feng
Pediatrics
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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 Hu Qi Feng
Pediatrics
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Symptoms of intussusception in infants

The clinical manifestations of intussusception mainly include abdominal pain, vomiting, bloody stools, and an abdominal mass. The abdominal pain is often spasmodic and regular, manifesting as sudden severe colicky pain. The child appears to be crying and restless, with knees drawn up to the abdomen, pale complexion, and the pain lasts for several minutes or longer but lessens after; it recurs every ten to twenty minutes, accompanied by intestinal movements. Vomiting is an early clinical symptom, initially consisting of milk curds or food residue, and later may include bile and fecal-like liquid. Bloody stool is an important symptom, appearing within the first few hours; initially, the stools can be normal, with about 85% of cases excreting jam-like mucoid bloody stools within six to twelve hours of onset. The abdominal mass is often located in the upper right abdomen below the costal margin, where a slight, tender mass can be palpated.

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Written by Hu Qi Feng
Pediatrics
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How many days will pneumatic reduction for intussusception take to recover?

The indications of successful reduction of intussusception by air enema treatment are as follows: First, after the removal of the tube, a large amount of foul-smelling mucousy bloody stool and yellow feces are expelled. Second, the patient quickly falls asleep, no longer cries, and ceases to vomit. Third, the abdomen is soft and flat, with no palpable mass as before. Fourth, after the enema reduction, 0.5-1 grams of activated charcoal is administered orally; if charcoal residue is expelled within six to eight hours, it indicates a successful reduction. However, even after successful reduction, it is necessary to remain under observation in the hospital for two to three days to monitor for any recurrence of the intussusception.

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Written by Hu Qi Feng
Pediatrics
51sec home-news-image

Causes of intussusception in children

The causes of intussusception are divided into primary and secondary types, with 95% being primary, commonly seen in infants and young children. In infants, the mesentery of the ileocecal area is not yet fully fixed and has greater mobility, which is a structural factor prone to intussusception. Secondary cases account for 5%, where intussusception occurs. Some intestines show clear organic changes, such as Meckel's diverticulum, intestinal polyps, intestinal tumors, intestinal duplication anomalies, abdominal purpura, and thickening of the intestinal wall, which can cause intussusception of the intestines. Certain triggers, including dietary changes, viral infections, and diarrhea, can induce intussusception.