Intussusception is the most common cause of pediatric intestinal obstruction, so what is intussusception? Intussusception is a type of intestinal obstruction caused by a segment of the intestine and its corresponding mesentery entering the distal intestine. In most cases, the small intestine enters the large intestine. In most cases, the small intestine has entered the large intestine. There are also cases where the small intestine is trapped into the large intestine after the small intestine is trapped. This disease is the most common acute abdominal disease in infancy. The incidence is high in China, accounting for the first place of intestinal obstruction in infants and children.
So what causes intussusception?
The cause is still not fully understood and is mainly related to the following aspects. Primary intussusception is mainly due to the following reasons.
(1), dietary changes and supplementary food stimulation.
Infancy is the period of intestinal peristaltic rhythm in a large change, prone to intestinal peristaltic disturbance, such as adding supplementary food or food nature, environment, temperature change, intestinal tube itself diseases such as enteritis induced intestinal peristaltic disturbance and cause intussusception.
(2), local anatomical factors.
Infants and young children are more mobile in the ileocecal part, the ileocecal flap is lip-like convex into the cecum, when the ileocecal peristalsis occurs abnormally, can pull the intestinal wall to form a lap.
(3), viral infection or other causes.
Causes ileocecal collection lymph node enlargement factors: pediatric adenovirus or rotavirus infection can cause terminal ileal collection lymph node hyperplasia, local intestinal wall thickening, and even the formation of swelling to the intestinal lumen protrusion constitutes the starting point of the sleeve, coupled with the intestine stimulated by viral infection or other causes, peristalsis is enhanced, leading to the onset of disease.
(4), immune response imbalance factors.
Primary intussusception mostly occurs within 1 year old, is the body’s immune function is not perfect period, the intestinal wall local immune function is easy to destroy, peristaltic disorder and induce intussusception. Secondary intussusception is caused by organic lesions in the intestinal wall or intestinal cavity, such as intestinal polyps, tumors, intestinal wall hematoma, Merkel’s diverticulum, intestinal cysts turned into the intestinal cavity, leading the intestinal wall as the starting point and causing intussusception, the incidence of about 2% to 5%.
What are the clinical manifestations of intussusception?
Intussusception is divided into small intestine intussusception and ileocolic intussusception according to the different parts of the intussusception. The most common type of intussusception is ileocolic, which has the following major symptoms.
Typical clinical manifestations of intussusception often have the following four early signs.
(1) Abdominal pain.
Intussusception can cause abdominal colic, which is manifested by the sudden appearance of obvious irritability and discomfort in a previously quiet child, and there may be generalized tonicity. The legs are flexed toward the abdomen, the expression is painful, and the symptoms are sudden and abrupt; the small infants who cannot express themselves show paroxysmal crying and quarreling, and they behave normally or fall asleep quietly between attacks.
(2), Vomiting.
The child’s abdominal pain attack is followed shortly by vomiting. The vomiting starts with undigested food such as milk, milk lumps or food residues, and may be followed by grass-green bile. The vomiting may be followed by general writhing, breath-holding, or even fecal-smelling liquid in severe cases.
(3), blood in the stool.
In the early stage of intestinal entrapment, the colon peristalsis increases, the intestinal lumen pressure rises, and the child excretes a small amount of normal stool.
(4), abdominal masses.
It is usually seen in the early stage of the disease. When the abdominal pain is relieved and the abdominal muscles are relaxed, parents can feel a lump like salami or banana in the right upper abdomen of the child. The lump is slightly elastic, smooth and slightly movable, which is the most valuable sign for diagnosing intussusception in children.
For atypical intussusception, there may be only abdominal pain, while vomiting, bloody stools, and other symptoms may not be obvious in the early stage, which makes early diagnosis difficult. We can also take some auxiliary tests to clarify whether or not you have intussusception.
What are the treatment options for intussusception?
There are two types of treatment, non-surgical and surgical. The main non-surgical treatment method is air enema repositioning therapy. Both methods are indicated by their own indications, and generally try to take the non-surgical method. If the disease does not exceed 48 hours, the general condition is good, no significant dehydration, no significant abdominal distension can be used enema therapy. If detected early, the success rate of air enema repositioning is more than 95%. Non-surgical treatment has the advantages of less trauma, faster recovery and lower cost. For those who have been ill for more than 2 days, or those who have not been ill for more than 2 days but are in poor general condition, with severe dehydration, peritonitis, highly distended abdominal manifestations, or multiple recurrences and small bowel entrapment, only surgical treatment is used. Compared to non-surgical treatment, surgical treatment has the disadvantages of high trauma, long hospital recovery time and high cost.
How to prevent the occurrence of intussusception.
There is no clear cause of intussusception, and it may be related to many factors, so there is no particularly good way to prevent it, but the main thing is to achieve early detection and early treatment, so as not to cause serious complications. What you can do is to eat hygienically, add supplementary food reasonably, and treat infectious diseases as early as possible. If a child has symptoms such as paroxysmal abdominal pain, vomiting or blood in the stool, seek medical attention promptly.