Clinical presentation:
Its three main typical symptoms are abdominal pain, bloody stools, and abdominal masses. The child is crying and restless, vomiting, and jam-like stools.
Treatment.
One surgical treatment, loosening and repositioning of intussusception.
The second non-surgical treatment is air enema repositioning of intussusception.
Indications for surgical treatment:
1, enema contraindications.
2, enema reset failure, or peritoneal irritation signs, suspected intestinal necrosis.
3, chronic intussusception or recurrent intussusception, suspected organic lesions.
4, suspected of small intestine type intussusception.
Indications for non-surgical treatment:
1, the duration of the disease does not exceed 48 hours, blood in the stool does not exceed 24 hours.
2, good general condition, no obvious dehydration acidosis and shock manifestations, no high fever that is respiratory distress.
3, the abdomen is not distended without pressure pain and muscle tension and other signs of peritoneal irritation.
Contraindications to non-surgical treatment:
1, the duration of the disease more than 48 hours blood in the stool more than 24 hours
2, poor general condition, with high fever, dehydration, depression and shock and other toxic symptoms
3, abdominal distension obvious abdominal pressure pain and tension with peritonitis suspected intestinal necrosis four, standing plain film shows complete intestinal obstruction.
Drug treatment.
1, antibiotics cephalosporins, cefmetazole, cefpiramide, cefoxitin, etc.
2, electrolytes, glucose solution, saline, potassium chloride, energy combination.
3.Nutrient solution, amino acid, fat milk, etc.
4.Intestinal probiotics, such as mometas, antidiarrheal, montelukast. Antipyretic agent, ibuprofen oral solution.
Air enema precautions.
Air enema reset preoperative preparation:Preoperative preparation, the child fasting and water fasting, the child crying and restless uncooperative, can be given sedative treatment. Pre-operative blood sampling to improve the admission examination, active rehydration. Accompanied by a doctor. Go to the radiology department to complete the air enema repositioning procedure. After the operation, pay attention to observe the fever, abdominal pain and diarrhea of the child, and report any abnormality to the doctor and nurse in time to give symptomatic treatment.
Postoperative care of air enema for intussusception.
For children with air enema reset, fasting and water fasting should be followed after the reset operation. After the recovery of intestinal peristalsis and exhaustion, and after the color of stool becomes normal, children can drink a small amount of water, and after no discomfort, they can eat breast milk, milk, or semi-liquid diet such as thin rice and rotten noodles, etc., and then gradually transition to general food. Do a good preoperative routine examination.
Intussusception loosening and repositioning care.
1, postoperative fasting, so as not to cause anastomotic fistula due to abdominal distension, to wait for the recovery of intestinal peristalsis, gastric tube removed after defecation by mouth to eat. Initially, the liquid diet – semi-liquid diet – soft diet – general diet.
2.Keep the gastrointestinal decompression and abdominal drainage tube unobstructed.
3.Give intravenous rehydration during fasting to correct water-electrolyte balance imbalance.
3.Give timely cooling treatment in case of high fever to prevent high fever convulsions.
4.According to the degree of recovery, follow the doctor’s orders to change the diet and eat a nutritious and easily digestible diet.
Postoperative guidance.
1.Bed rest on the day after surgery
2.Activity in bed on the second day after surgery, turning and sitting up, etc.
3. 2 to 4 days after surgery, you can go down to indoor activities.
Rehabilitation guidance.
1, should eat nutritious, high vitamin easy to digest food, less to drink spicy too cold and other stimulating food.
2, regular diet, avoid overeating after meals avoid strenuous activities.
3, pay attention to dietary hygiene, wash hands before and after meals, do not eat unclean food.
4.Prevent upper respiratory tract infection in spring and autumn and avoid the occurrence of enteritis and diarrhea.
Discharge guidance;
1.Rest for one month, reasonably match the child’s diet and establish good regular eating habits. Avoid too cold food.
2.Prevent upper respiratory tract infections in spring and autumn and avoid the occurrence of enteritis and diarrhea.
3.Strengthen self-testing, if abdominal pain, bloating, vomiting, stopping bowel movement and other conditions promptly seek medical attention.
4.Regularly review and observe the condition of the incision after surgery.