Intussusception
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| Intussusception |
Intussusception
Is an invagination or telescoping of a portion of the intestine into another, resulting in obstruction beyond the defect.
Aetiology:
Not usually known, may be due to increase motility of intestine.Possible causes:
Polyps or cysts in the bowel, malrotation, acute enteritis, abdominal, injuries, abdominal surgery, cystic fibrosis, celiac disease.Altered physiology:
Intestine become curved, sausage-like blood supply is cut off bowel begins to swell haemorrhage may occur and complete obstruction may occur necrosis of involved segment.Classification:
Iileocecal ( most common ) , colocolic , ileoileo .Clinical manifestations:
- ( 4-10 months ) is the most common age.- Onset is sudden, paroxysmal abdominal pain.
- Current jelly-like stool, blood and mucus present in stool ( following rectal exam).
- Vomiting.
- Abdominal distention.
- Sausage-like mass palatable in the abdomen.
- Dehydration.
- Fever.
- Shock.
Diagnostic evaluation:
- History.- General appearance.
- X-Ray abdomen: reveals staircase pattern.
- Barium enema: the coil-like appearance of the bowel.
Treatment:
- Hydrostatic reduction with the barium enema.- Surgical reduction, resection if the bowel is gangrenous.
Patient problems:
- Altered comfort level ( pain ) related to invagination of the bowel.- Alteration in fluid and electrolyte balance related to vomiting.
- Respiratory distress related to abdominal distention.
- Parental anxiety related to the suddenness of the child's illness, hospitalization, surgery, the lake of Understanding of the condition.
- N.G. tube may be inserted to prevent vomiting and aspiration.
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