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  Child Intusussception





 
 
 What is a Intussusception ?
 Why are the symptoms?
 How is it diagnosed ?
 What is the treatment ?
 What is the outcome ?
 
What is a Intussusception ?
In this condition a segment of small bowel goes inside another bowel segment further downstream. This leads to blockage of bowel. It typically affects babies of 6-9 months age. The exact cause of this problem is not known. It could be initiated by weaning of milk or a mild viral infection.
Why are the symptoms ?

The baby starts to cry in a high pitch due to pain. Some babies pass blood mixed with slime. They refuse feeds and may also start vomiting yellow liquid. Also the baby gets dehydrated and tired over time.

How is it diagnosed ?

A bowel mass may be felt during examination. Ultrasound scan shows the bowel mass like a 'doughnut'.

What is the treatment ?

The baby needs to be admitted for IV fluids and correction of abnormalities in salt content of the body, which is often present because of vomiting. If the baby is brought soon enough, the bowel can be put back with the help of air enema. In this air is pumped up the bottom under x-ray and the bowel is reduced back. If this fails or the baby is brought late, surgery is required. Under general anaesthesia, through a small cut in the belly, the bowel mass is reduced manually. If this fails, the affected portion needs to be removed and continuity restored.

What is the outcome ?

After x ray reduction the intussusception can come back in 10-20%. Even after open surgery there is a 5% chance for recurrence. In the long term there may be bowel obstruction in 10% of children due to adhesions; In this, the bowel gets stuck inside the tummy and a blockage results. The parents need to watch out for, pain, vomiting and tummy distension. If these happen, an x-ray is required to look for obstruction. Surgery may be required to correct this.

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