Intussusception is an intestinal obstruction caused by a segment of the intestinal canal and its corresponding mesentery snapping into the adjacent intestinal cavity, and is one of the most common acute abdominal conditions in infancy.
Acute intussusception is a unique disease in infancy, which is common within 1 year of age, and is more common in infants aged 4-10 months, and gradually decreases with age after 2 years of age, and is rare at 5 years of age.
Possible causes 1. Dietary changes. 4-10 months after birth is the period of adding complementary foods and increasing the amount of milk, which is also the peak period of intestinal entrapment. Because the infant’s intestine cannot immediately adapt to the stimulation of the changed food, resulting in intestinal dysfunction, causing intussusception; 2. Ileal anatomical factors. Infants 90% of the ileocecal flap is lip-like convex into the cecum, more than 1cm long, coupled with the rich lymphatic tissue in this area, inflammation or food stimulation is easy to cause congestion, edema, hypertrophy, intestinal peristalsis easy to push the ileocecal flap forward, and pull the intestinal tube to form a ligature; 3, virus infection. Intussusception is related to adenovirus and rotavirus infection in the intestine; 4, intestinal spasm and autonomic dysregulation. Due to various foods, inflammation, diarrhea, bacteria or parasitic toxins, etc. stimulate the intestinal tract to produce spasm, so that the intestinal peristaltic function rhythm disorder or retroperistalsis and cause intestinal entrapment; 5, genetic factors.
Typology: 1. small intestine type; 2. ileocecal type; 3. ileocolic type; 4. colic type; 5. complex type or compound set type; 6. multiple type.
Common manifestations: Pediatric intussusception is divided into infantile intussusception (within 2 years) and pediatric intussusception Infantile intussusception: (1) Paroxysmal crying and restlessness. Sudden onset of paroxysmal regular crying, lasting about 10-20 minutes, accompanied by fidgeting, pale face, refusal to eat, abnormal pain performance, and then 5-10 minutes or more of temporary quiet, and so on repeatedly; (2) vomiting. Initially milk and milk lumps or other foods, later turning into bile-like material; (3) abdominal masses; (4) jam-like stools.
Intussusception in children: paroxysmal abdominal pain with longer intervals than in infants, vomiting is less common. Jam-like stools appear only after a few days of entrapment. A mass may be palpable in the abdomen.
Treatment Indications for barium enema: the duration of the disease does not exceed 48 hours, good general condition, no obvious dehydration and electrolyte disorders, no obvious abdominal distension and peritonitis manifestations. The pressure should be controlled at 60-100 mmHg, and the pressure for infants under 3 months of age with intussusception and diagnostic enema should not exceed 80 mmHg. Contraindications: The duration of the disease is more than 2 days, and the systemic condition is significantly poor; high abdominal distension, significant abdominal pressure and muscle tension, suspected peritonitis; repeated intussusception, highly suspected or diagnosed as secondary intussusception; small intestine intussusception; infants under 3 months .
Complications: intestinal perforation.
Surgical treatment.