Pediatric intussusception should see which department?

Written by Hu Qi Feng
Pediatrics
Updated on September 25, 2024
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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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Intestinal intussusception described by ultrasound.

The appearance of intussusception under ultrasound shows concentric or target ring-shaped mass images on a transverse section scan, and a sleeve sign on a longitudinal section scan. For an ultrasound-guided hydrostatic reduction, a balloon is inserted through the anus and inflated, connecting a T-tube to a Foley catheter with a side tube connected to a sphygmomanometer to monitor water pressure. Isotonic saline at a temperature of thirty to forty degrees is injected, and the target ring-shaped mass image can be seen retracting to the ileocecal region. The disappearance of the concentric circles or sleeve sign under ultrasound indicates the completion of this therapeutic diagnosis.

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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 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 Bai Yan Hui
Pediatrics
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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.