Beware of intussusception in children

This is the 4627th article of Da Yi Xiao Hu

The baby in the neighbor's house has been crying for an entire afternoon, so the mother hurriedly took the baby in her arms and took a taxi to the hospital to see a doctor. After examination, the doctor said that the baby was "stuck", and the medical name is "intussusception", and immediate treatment is required. If not treated in time, it will cause necrosis of the intestinal tube in the baby's stomach, and may even cost the baby's life. Intussusception in children Intussusception is one of the more common diseases in babies, so it is necessary for the little brothers and sisters who take care of the baby to understand "intussusception".

1. What is intussusception in children?

In layman's terms, intussusception refers to two adjacent intestinal tubes. Due to various reasons, one of the intestinal tubes is inserted into the other intestinal tube (see the figure below), that is, the proximal intestinal tube and the distal intestinal tube are stacked together. It is similar to the state when the handle of a telescopic suitcase is folded. It is one of the common acute abdomens in children with a high incidence rate. It is more common in infants and young children, 80% of whom are less than 2 years old. The main reason is that there is a part of the baby's intestines (ileocecal mesentery) that is not completely fixed.

2. What causes intussusception in children?

1. Related to diet

One of the triggers of intussusception in children is a sudden change in diet. When babies are in the transition period of feeding complementary foods, some babies have difficulty adapting to the stomach and intestines. If too many types of complementary foods are added, it will have a certain impact on the baby's gastrointestinal function, thus causing intussusception. In addition, if the baby eats too cold or other irritating foods, it will also bring adverse stimulation to the intestines, thereby causing increased intestinal peristalsis and intestinal spasms, which will then lead to intussusception.

2. Virus-related

Viral infection is a common cause of intussusception. If the baby is infected with adenovirus or rotavirus, it may cause acute intussusception. This is mainly because the virus infection will cause inflammation and edema of the intestines, narrowing of the intestinal cavity, and local depression of the intestines, which will gradually overlap and cause intussusception.

3. Related to cold

The baby's resistance is relatively weak, and any external invasion may cause uncomfortable symptoms. If the baby's abdomen is cold, it will increase gastrointestinal motility, thus causing intussusception.

4. Related to genetics

For some children with intussusception, their parents also had this disease when they were young.

3. How to identify intussusception in children early?

1. Abdominal pain

As the earliest symptom, healthy infants and babies will suddenly have paroxysmal and regular crying and noise, which will last for 15-30 minutes, accompanied by trembling hands and feet, pale face, refusal to eat, abnormal pain, etc. It is especially important to note that some infants and babies with poor general conditions do not show obvious symptoms mentioned above.

2. Vomiting

In the early stage, vomitus is milk, milk curds, other food residues or bile, while in the late stage, it is foul-smelling intestinal contents.

3. Lump

Most babies with the disease may feel a local bulge on the right side of their abdomen, which is shaped like a large sausage.

4. Jam-like mucus and blood in stool

The baby's bowel movements may be normal in the first few hours, and then gradually decrease or even disappear. As time goes by, most children may pass jelly-like mucus and blood in their stools, which is the most typical manifestation of intussusception.

4. What happens if intussusception in children is severe?

Intussusception is an acute abdomen. If you find that your baby has symptoms of intussusception, you should send him to the doctor immediately. If it is discovered early and treated promptly, there will generally be no serious consequences. Generally, he will recover after 1-2 days of observation after treatment. However, if the discomfort symptoms of the baby are not discovered in time and the best treatment opportunity is delayed, it may cause intestinal necrosis, intestinal perforation, etc., and his life will be in danger.

5. How to treat intussusception in children?

Within 12 hours of the onset of intussusception, if the baby is still in good condition, air enema repositioning therapy can be used. That is, a colon insufflation machine with automatic pressure control is used, and a special enema tube is inserted into the anus. After gradually injecting gas from the anus, the mass of intussusception can be seen to gradually shrink until it disappears completely. The repositioning rate of air enema is very high, reaching more than 95%. If the intussusception lasts for more than 12 hours, it is necessary to cooperate with the doctor for surgical treatment.

6. Will intussusception recur in children?

Yes! Therefore, after the baby is successfully repositioned in time, it is also necessary to prevent the recurrence of pediatric intussusception and be vigilant at all times! Therefore, prevention needs to be strengthened in daily life.

7. How to prevent it in daily life?

1. Scientific feeding

Younger sisters or older brothers should know that it usually takes 5-7 days for their younger brothers or sisters to adapt to new food. When adding complementary food, remind adults not to be too anxious, and to proceed step by step. New food can be added only after the baby has adapted to the previous food. Sequence: from less to more, first thin then thick, first fine then thick. Do not add new complementary food in hot summer or when the baby is not in good health.

2. Be diligent in observation

Younger sisters or older brothers should also pay more attention to their younger brothers or sisters not to do strenuous exercise after a full meal. They should also pay attention to help adults detect physical changes in their younger brothers or sisters as early as possible so that the affected children and babies can receive timely treatment.

3. Avoid infection

Younger sisters or older brothers should also pay attention to personal hand hygiene when taking care of their younger brothers or sisters, and wash their hands before and after meals to avoid viral infection, thereby preventing intussusception. They should also pay attention to weather changes with adults, add or remove clothes in time, and avoid colds and diarrhea.

References:

[1] Xie Bing. Prevention, treatment and care of intussusception in children[J]. Family Medicine, 2022, 5(15): 34

[2] Qu Bin. Experience in the application of comprehensive nursing intervention in the treatment of pediatric intussusception[J]. Chinese Journal of Metallurgical Industry Medicine, 2020, 37(4): 433-434.

[3] Chen Xiaoping, Wang Jianping, Zhao Jizong. Surgery[M]. 9th edition. People's Medical Publishing House, 2018

Author: Shanghai Yangpu District Siping Community Health Service Center

Zhu Tonghua, deputy chief nurse