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 He Zong Quan
General Surgery
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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.

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Written by Yao Li Qin
Pediatrics
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Intussusception: How to Diagnose

Intussusception is one of the most common acute abdominal conditions in infants and toddlers, primarily seen in children under one year old. It refers to the condition where part of the intestine and its mesentery slip into an adjacent intestinal lumen, causing obstruction at the root of the intestine. The diagnosis of intussusception in children is mainly based on clinical symptoms. A previously healthy child may suddenly experience an episode of severe, regular, intermittent colicky pain. The child may appear restless, crying, with knees bent, a reduced amplitude of movement, and a pale complexion, with the abdominal pain easing after 10 to 20 minutes. The child may also vomit and pass bloody stools. Bloody stools are a very important symptom; approximately 85% of cases will pass jelly-like, mucousy bloody stools within 6 to 12 hours of onset, or even if there is no bloody stool visible, rectal examination can reveal its presence. A sausage-shaped mass can be felt in the abdomen. Furthermore, an ultrasound can show a typical image of a concentric circle or target-sign mass. Under ultrasound monitoring, procedures such as air or hydrostatic enema can be performed, which help in the early diagnosis of intussusception.

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Written by Hu Qi Feng
Pediatrics
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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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Written by Hu Qi Feng
Pediatrics
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Can infantile intussusception heal by itself?

Once intestinal intussusception occurs, only a small portion of small bowel intussusception can reduce spontaneously, becoming temporary small bowel intussusception, while intussusception involving the colon or repeated intussusception generally cannot reduce on its own. Due to the continuous spasm of the sheathed intestine, circulatory disturbances occur in the intussuscepted segment, initially impeding venous return, causing tissue congestion and edema, varicose veins, and mucous cells secreting large amounts of mucus into the intestinal lumen. This results in a jam-like gelatinous discharge mixed with blood and fecal matter. The bowel wall swells, worsening the obstruction of venous return, affecting the arteries, leading to insufficient blood supply, causing necrosis of the intestinal wall, and systemic toxicity symptoms. In severe cases, this can lead to intestinal perforation and peritonitis. Treatment generally involves air or barium enema or surgical methods.

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Written by Hu Qi Feng
Pediatrics
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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.