How many days will pneumatic reduction for intussusception take to recover?

Written by Hu Qi Feng
Pediatrics
Updated on September 19, 2024
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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
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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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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.

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Does intussusception require a CT scan?

Intussusception is commonly diagnosed through routine abdominal ultrasound examinations, which have a positive rate of over 90%. In the ultrasound, the transverse section of the intussusception can show concentric circles or target ring-shaped mass images, and the longitudinal section may reveal the sleeve sign. Additionally, a barium enema can be employed, along with X-ray imaging. Under X-ray, the lead point of intussusception appears as a mass shadow, and air enema reduction treatment can be performed concurrently. Generally, CT is not used as a routine diagnostic tool.

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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.

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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.