Intussusception in children is the invagination of one segment of the intestine into another, and is one of the common causes of intestinal infarction in children under two years of age. The cause is that the lymphoid tissue in the terminal ileum is swollen due to upper respiratory tract infection or gastroenteritis, causing the terminal ileum to insulate the caecum and colon; it is also occasionally caused by intestinal diseases such as Meckel’s diverticulum and polyps. 75% of the cases were in infants and young children before the age of two, with the highest incidence in children aged 5 to 9 months.
Intussusception can occur anywhere in the intestinal tract, but is more common at the junction of the large and small intestines. When the small intestine is peristaltic, it will be trapped in the large intestine, which will affect the blood supply and cause intestinal necrosis in severe cases. Intussusception usually comes on quickly. In the early stage of young children, there will be paroxysmal abdominal cramps. The pain is intermittent, but the pain is severe. Young children cannot express it. Feet curled and belly shrunk.
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The casing can also hinder normal bowel movements and cause vomiting. If the diagnosis is not made in time, the patient’s condition will continue to deteriorate, and the excretion of stool is mixed with blood and intestinal mucus, in the shape of red berry jelly. An intestinal blockage can make the abdomen swell and make it impossible to get rid of gas.
The occurrence of intussusception in infants and young children under the age of two is mostly related to the swelling of abdominal lymph nodes caused by upper respiratory tract infection or gastroenteritis. Intussusception has also been reported in older boys in clinical experience, and risk factors include intestinal polyps or tumors and previous abdominal surgery. Intussusception is an emergency and must be diagnosed and treated early to avoid ischemia and necrosis of the tightly clamped intestinal tissue.
The doctor will use ultrasound examination to confirm the patient’s intussusception, and arrange the patient to undergo a gas enema repositioning treatment commonly known as “pump intestine”. Angiography to monitor progress. Enema reduction is a non-surgical treatment method with a success rate of regarding 80%. It is not suitable for patients with peritonitis and intestinal perforation.
If reduction of the enema fails, or treatment is not possible due to contraindications, emergency surgery may require general anesthesia. Surgical methods are divided into the use of laparoscopy or laparotomy to remove the intussusception, and to check whether there are signs of intestinal necrosis.
The full text was published in Hong Kong Economic Times, with the original title of“Intussusception is common in infants under two years of age”title modified by TOPick editors.
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Written by: Stuart Dayan, Specialist in Pediatric Surgery
Column Name: Friends Health
Written by: Stuart Dayan Specialist in Pediatric Surgery
