Childhood illnesses

Intussusception in children, the most common cause of intestinal obstruction


Parents must bear in mind that the baby's crying can not only be due to hunger, and I say this because many times the little one is manifesting other needs such as affection, attention or pain. This circumstance makes us fall into serious errors, such as when we confuse or obviate that through his crying he is expressing a disease that could be very serious, such as intussusception, the most common cause of intestinal obstruction in children. Do you know what is it about?

It is when a portion of the intestine is introduced into a segment immediately caudal to it. They call it the "telescope effect." This is a pediatric emergency and is the most common cause of intestinal obstruction between 3 months and 6 years of age. Below 3 months it is rare. Another characteristic of this pathology is that it is more frequent in males (4/1 ratio). Its incidence is between 1 to 4 per 1,000 live births and a higher incidence has been seen during the spring and fall.

Most intussusception is idiopathic, that is, the cause is unknown, but a relationship has been seen with certain pathologies: after respiratory infections due to adenovirus, as a complication of gastroenteritis and in patients with cystic fibrosis.

In the case of children, which is the one that worries us most, it has been seen in young children after the introduction of solid foods, after the administration of anticancer chemotherapy and when there is a family history of the same disease.

The intussusception it can be spontaneously reduced if it is treated in time (before 24 hours to avoid complications) because, otherwise, it can cause intestinal perforation, infections, shock and death in untreated cases. Hence, parents know, although we are not doctors, to detect certain symptoms in our little one that may be alerting us to this type of obstruction:

- They are usually healthy children who suddenly start with a loud crying.

- Abdominal pain sudden onset, colic, paroxysmal, intense, which recurs with frequent intervals and gradually increases.

- Vomiting frequent food content, which then become bilious.

- Evacuations normal at the beginning and, later, there may be absence of them or a characteristic evacuation called “stool in currant jelly” due to the presence of red blood and mucus, characteristic of this disease

- Sweating, paleness and decay.

- On palpation of the abdomen, a sausage dough, somewhat painful and that can increase in size during the crisis, usually located in the upper right part of the abdomen.

How is a prognosis for this disease reached? Everything is done by the clinic and the physical signs that are very characteristic. The standing plain abdominal X-ray can help us by observing a dense area at the intussusception site. And when doing a rectal examination, in general, there will be the presence of a bloody mucus that guides us with the diagnosis.

If it does not resolve spontaneously, treatment will be surgical with reduction of the invaginate segment, which should be done immediately. 75% of the cases that arrive on time can be resolved by hydrostatic or pneumatic pressure under fluoroscope or ultrasound control. If manual reduction is not achieved or the bowel is not viable, the intussusception is resected and an end-to-end anastomosis is performed.

You can read more articles similar to Intussusception in children, the most common cause of intestinal obstruction, in the category of Children's Diseases on site.

Video: Intussusception - an Osmosis preview (September 2020).