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intussusception
Why does intussusception cause bloody stool?
Once intussusception occurs, only a small portion of the small intestine intussusceptions can reset themselves. Due to the continuous spasm of the sheathed intestinal tract, microcirculatory disorders occur in the intussuscepted segment. Initially, venous blood flow is obstructed, leading to tissue congestion and edema, venous varicosity, and mucosal cells secrete a large amount of mucus into the intestinal lumen, which mixes with blood and feces to form a jam-like jelly substance that is expelled. The intestinal wall becomes edematous, and the obstruction of venous return worsens, affecting the arteries, resulting in insufficient blood supply, and leading to systemic toxic symptoms. In severe cases, intestinal perforation and peritonitis can occur.
Is intussusception in children serious?
Intussusception is a life-threatening emergency, and its reduction is an urgent medical treatment that must be performed immediately once diagnosed. Generally, in the early stages of intussusception, the general condition is still good, with normal body temperature and no symptoms of systemic toxicity. As time progresses, the condition worsens, and there may be necrosis of the intestines or peritonitis, with overall health deteriorating. Common severe symptoms include dehydration, high fever, lethargy, coma, and shock from toxicity.
How to treat intussusception in children?
Intussusception is a life-threatening emergency that requires urgent reduction once diagnosed. Reduction methods include non-surgical and surgical therapies. Within forty-eight hours of intussusception, if the overall condition is good, there is no abdominal distension, and no significant dehydration or electrolyte imbalance, reduction can be attempted under ultrasound guidance using hydrostatic enema, air enema, or barium enema. If the intussusception has lasted beyond forty-eight to seventy-two hours, or if there is severe abdominal distention, intestinal necrosis, or perforation, surgical treatment is necessary.
Can intussusception heal itself?
Once intestinal intussusception occurs, only a small part can be spontaneously reduced. In most cases, urgent reduction treatment is required, including non-surgical and surgical treatments. Non-surgical treatment mainly involves enema therapy. Within 48 hours of the intussusception, if the overall condition is good, the abdomen is not distended, and there are no obvious signs of dehydration or electrolyte imbalance, barium enema treatment can be applied. If the duration of the intussusception exceeds 48 to 72 hours, or if the condition is severe with intestinal necrosis or perforation, surgical treatment is necessary.
Infant intussusception symptoms
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.
What department should I go to for infant intussusception?
Intussusception often occurs in infants and young children, mainly presenting with vomiting, abdominal pain, and bloody stools. The first department usually visited is the emergency pediatrics. If intussusception is confirmed, treatment may involve surgery or non-surgical reduction. Therefore, after confirming intussusception, the patient needs to be transferred to pediatric surgery or general surgery for inpatient treatment.
Can intussusception resolve itself automatically?
Some children with intussusception may resolve spontaneously, but it is important to closely monitor their condition with ultrasound to understand the status of the intussusception. If it does not resolve on its own in a short period, immediate surgical treatment is necessary. If the ultrasound shows successful resolution, or if the child's clinical symptoms such as vomiting and abdominal pain improve and the ultrasound does not reveal any obvious abnormalities, it is considered an automatic recovery.
Can infants with intussusception sleep?
Intussusception presents as abdominal pain, which occurs in sudden, severe, and periodic episodes. The child cries restlessly with a pale face, and the pain lasts several minutes or longer. The pain then subsides, and during this relief, the child falls asleep. The pain reoccurs every ten to twenty minutes. Continuous episodes occur until the intussusception is successfully reduced, after which the child calms down and falls asleep without further crying or vomiting.