Acute intussusception is a common acute abdominal disease in children, with “paroxysmal abdominal pain (or crying), blood in stool, and rapid abdominal packing” as the main clinical manifestations; some children have less obvious abdominal pain, with “vomiting, poor mental health, and blood in stool” as the main manifestations. Of course, at a later stage, the child may develop abdominal distension and even life-threatening shock. Before the appearance of blood in the stool, it is easy to misdiagnose as “acute gastroenteritis”, and even after the appearance of blood in the stool, it can be misdiagnosed as “bacillary dysentery”.
Based on the above manifestations, it is not difficult to make a diagnosis, but the misdiagnosis rate is high because the child does not cooperate with the medical examination and is not a professional pediatric surgeon. We have to use auxiliary examinations, among which ultrasound is easy to perform and has a high positive rate of diagnosis. Anal examination is one of the effective means of early detection of bloody stools, and in addition, in patients with unclear diagnosis, diagnostic air enemas can be applied to make the diagnosis.
There are two main methods of treatment: air enema and surgical treatment.
1, air enema Indications and contraindications: intussusception not more than 48 hours, good general condition, no obvious dehydration and ionic disorders, no obvious abdominal distension can be used air enema therapy. Contraindications are: (1) the duration of the disease more than 2 days, the systemic condition is significantly poor, such as severe dehydration, depression, hyperthermia or shock and other symptoms, should pay particular attention to infants under 3 months; (2) a high degree of abdominal distension, abdominal pain, muscle tension, suspected peritonitis, X-ray abdominal plain film can be seen in most of the fluid plane; (3) small intestine type intussusception.
Some hospitals also apply barium enema reset and B ultrasound water enema reset, the indications contraindications as above.
2.Surgical treatment For air enema reset failure; suspected intestinal necrosis; disease duration more than 2 days, the systemic condition is significantly poor, such as severe dehydration, depression, hyperthermia or shock, especially for infants under 3 months; high abdominal distension suspected peritonitis; small intestine overlap; multiple recurrence of suspected organic lesions are indications for surgery.
Finally, many parents of patients may ask, “What is the cause of this disease?
I will tell you that the cause and pathogenesis of acute intussusception are still unknown, and 95% of infants with intussusception are primary. It may be caused by the imperfect fixation of the infant’s ileocecal ligament, which makes the ileocecal part move too much. 5% of children have secondary intussusception, which is caused by obvious mechanical causes on the intestinal wall, such as Merkel’s diverticulum, intestinal polyps, tumors, and allergic purpura, which tug on the intestinal wall. Most people believe that it is caused by disturbances in the normal rhythm of intestinal peristalsis, such as enteritis, diarrhea, changes in diet regime, and fever. Others believe that the inflammatory response of a certain virus causes disturbance of intestinal peristalsis, causing intussusception.
Some parents ask if there is any way to prevent the occurrence of this disease.
The main thing is not to eat irritating food, to treat intestinal disorders such as diarrhea as soon as possible, and to treat suspected intussusception at a specialist hospital, or to do ultrasound in the local area.