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How do i know if my child has a bowel obstruction


Intussusception (for Parents) - Nemours KidsHealth

What Is Intussusception?

Intussusception (in-tuh-suh-SEP-shun) happens when one part of the bowel slides into the next, much like the pieces of a telescope.

When this "telescoping" happens:

  • The flow of fluids and food through the bowel can get blocked.
  • The intestine can swell and bleed.
  • The blood supply to the affected part of the intestine can get cut off. In time, part of the bowel can die.

Intussusception is a medical emergency that needs care right away. It's the most common abdominal emergency in children under 2 years old.

What Are the Signs & Symptoms of Intussusception?

Babies and children with intussusception have intense belly pain that:

  • often begins suddenly
  • makes the child draw the knees up toward the chest
  • makes the child cry very loudly

As the pain eases, the child may stop crying for a while and seem to feel better. The pain usually comes and goes like this, but can be very strong when it returns.

Symptoms also can include:

  • a swollen belly
  • vomiting
  • vomiting up bile, a bitter-tasting yellowish-green fluid
  • passing stools (poop) mixed with blood and mucus, known as currant jelly stool
  • grunting due to pain

As the illness continues, the child may:

  • get weaker
  • develop a fever
  • appear to go into shock. In this life-threatening problem, a lack of blood flow to the body's organs makes the heart beat quickly and blood pressure drop.

What Causes Intussusception?

Most of the time, doctors don't know what causes intussusception. In some cases, it might follow a recent attack of gastroenteritis (or "stomach flu"). It also can follow a cold or the flu. Bacterial or viral gastrointestinal infections can make the infection-fighting

lymphtissue that lines the intestine swell. This can cause part of the intestine to get pulled into the other.

In kids younger than 3 months old or older than 5, intussusception is more likely to be caused by an underlying condition like enlarged lymph nodes, a tumor, or a blood vessel problem in the intestines.

Intussusception is most common in babies 5 to 9 months old, but older children also can have it. Boys get intussusception more often than girls.

How Is Intussusception Diagnosed?

Doctors usually check for intussusception if a child keeps having periods of pain, drawing up the legs, vomiting, feeling drowsy, or poop with blood and mucus.

During the visit, the doctor will:

  • do an exam, paying special attention to the belly, which may be swollen or tender to the touch. Sometimes the doctor can feel the part of the intestine that's involved.
  • ask about the child's health, family health, any medicines taken, and any allergies

How Is Intussusception Treated?

If the doctor suspects intussusception, the child may be sent to an emergency room (ER). Usually, doctors there will ask a pediatric surgeon to see the child right away. The ER doctor might order an abdominal ultrasound or X-ray, which can sometimes show a blockage in the intestines. If the child looks very sick, suggesting damage to the intestine, the surgeon may take the child to the operating room right away to fix the blocked bowel.

Two kinds of enemas often can diagnose and treat intussusception at the same time:

  • In an air enema, doctors place a small soft tube in the rectum (where poop comes out) and pass air though the tube. The air travels into the intestines and outlines the bowels on the X-rays. If there's intussusception, it shows the telescoping piece in the intestine. At the same time, the pressure of the air unfolds the inside-out section of bowel and cures the blockage.
  • In a barium enema, a liquid mixture called barium is used instead of air to fix the blockage in the same way.

Both types of enema are very safe, and children usually do very well. Most children treated with the enema do not need surgery. In a few children, intussusception can return, usually within 72 hours of the procedure. They may need a repeat enema.

A child will need surgery if the intestine is torn, an enema doesn't work, or the child is too sick for an enema. This is often the case in older children. Then, surgeons will try to fix the obstruction. But if too much damage has been done, they may need to remove that part of the bowel.

After treatment, the child will stay in the hospital and get IV feedings until they can eat and have normal bowel function. Doctors will watch the child to make sure that the intussusception does not come back. Some babies also may get antibiotics to prevent infection.

When Should I Call the Doctor?

Intussusception is a medical emergency. Call your doctor or get emergency medical help right away if your child has any symptoms of intussusception, such as:

  • repeated crampy belly pain
  • vomiting
  • drowsiness
  • passing of currant jelly stool

Most children treated within the first 24 hours recover completely with no problems. But untreated intussusception can cause serious problems that get worse quickly. So it's important to get help right away — every second counts.

Pediatric Small Bowel Obstruction Clinical Presentation: History, Physical Examination

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  108. Stevenson DK, Kerner JA, Malachowski N, Sunshine P. Late morbidity among survivors of necrotizing enterocolitis. Pediatrics. 1980 Dec. 66(6):925-7. [QxMD MEDLINE Link].

  109. Minney-Smith CA, Levy A, Hodge M, et al. Intussusception is associated with the detection of adenovirus C, enterovirus B and rotavirus in a rotavirus vaccinated population. J Clin Virol. 2014 Dec. 61(4):579-84. [QxMD MEDLINE Link].

  110. Pammi M, Abrams SA. Oral lactoferrin for the prevention of sepsis and necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev. 2015 Feb 20. 2:CD007137. [QxMD MEDLINE Link].

  111. Ogle SB, Nichol PF, Ostlie DJ. Duodenal and intestinal atresia and stenosis. In: Holcomb GW III, Murphy JP, St Peter SD, eds. Holcomb and Ashcraft's Pediatric Surgery. 7th ed. Philadelphia, Pa: Elsevier; 2020. ch 30.

Acute intestinal obstruction: causes, symptoms, treatment

Violation of the passage of contents through the intestines or adhesions leads to such an unpleasant problem as intestinal obstruction.

Causes

Acute intestinal obstruction is an independent functional disorder, a consequence of other pathologies or injuries. The problem can be caused by:

  • peritonitis,
  • heavy metal salt poisoning,
  • neoplasms,
  • jumps in intra-abdominal pressure,
  • gallstones,
  • infectious diseases,
  • a sharp decrease in body weight,
  • vascular thrombosis,
  • disorders of the stomach.

Acute obstruction: classification

  • If hemodynamics, innervation (connection of internal organs with the central nervous system) is disturbed, then they speak of mechanical intestinal obstruction.
  • Intestinal obstruction associated with compression of the intestinal lumen and compression of blood vessels is called strangulation. nine0014
  • If adhesions are the cause, the patient is diagnosed with acute adhesive ileus.
  • The result of paralysis, paresis - the so-called paralytic ileus.

Intestinal obstruction can be decompensated (no stool, signs of detoxification, anemia are pronounced), subcompensated (persistent constipation, the colon is significantly expanded, stool - with the help of enema, a large amount of laxative) and compensated (irregular stool, effective solution to the problem of constipation with laxatives). nine0003

Symptoms of intestinal obstruction

Symptoms affect both the gastrointestinal tract itself and other organs and systems of the body:

  • Cramping pains in the abdomen (pain is not “tied” to eating).
  • Constipation.
  • Increased flatulence, bloating.
  • Vomiting (often, but not always - may be absent in colonic obstruction).
  • Rapid pulse.
  • Pale skin.
  • Without a medical diagnosis, a person can decide that the problem is an exacerbation of chronic colitis, an infectious disease, and even heart problems.

Diagnosis

The main methods of diagnosis are auscultation and percussion of the abdomen. In addition, important information for making a diagnosis can be obtained as a result of colonoscopy and fluoroscopy - always with a contrast agent.

Laboratory diagnostics is also important, especially a general and detailed biochemical blood test, including the determination of the level of chlorides, leukocytes and nitrogen. nine0003

The patient is also given a urine test. If cylinders, protein and blood elements appear in the urine, the disease progresses.

Treatment

Treatment is aimed at restoring intestinal patency, simulating motility, combating spasms and gas formation, and restoring electrolytes in the body.

In the initial stages, therapeutic methods are used, with the progression of the disease, severe obstruction, volvulus of the intestine and closure of the lumen, surgical intervention is required. nine0003

In case of intestinal volvulus, nodulation, an operation is performed to eliminate the node. If there are no signs of peritonitis, but the disease progresses strongly, a colostomy and hemicolonectomy are performed. If peritonitis has developed, surgeons perform a transversostomy.

Prevention

A significant problem is the recurrence of the disease. To prevent them, it is important to remember about prevention. What it includes:

  1. Small meals and elimination of foods that cause gas in the intestines. nine0014
  2. Regular biochemical blood test, abdominal ultrasound and colonoscopy.
  3. Injury avoidance.

If signs of intestinal obstruction reappear, it is important to see a doctor immediately. It is also important to deal with the prevention of adhesion formation for everyone who has a tendency to form adhesions. These people are a special risk group.

You can undergo intestinal diagnostics and receive high-quality surgical treatment for intestinal obstruction at the 5th clinical hospital in Minsk. Attentive and experienced doctors work here to help defeat the disease. nine0003

Acute intestinal obstruction - symptoms, treatment, diagnosis

Acute intestinal obstruction is a life-threatening pathological condition that is characterized by a violation of the passage of the contents of the gastrointestinal tract from the stomach to the anus. It is not an independent disease and is a complication of a variety of diseases. However, having arisen, intestinal obstruction develops according to a single scenario and is accompanied by typical clinical manifestations. In the absence of timely treatment, the prognosis for intestinal obstruction is extremely unfavorable. nine0003

Of great importance is the level at which intestinal obstruction occurred. The higher the obstacle arises, the more difficult it is, the more vigorous therapeutic measures it requires.

Types of intestinal obstruction

It is customary to distinguish between dynamic intestinal obstruction, when the motor function of the intestinal wall is disturbed (i.e., peristalsis is disturbed and the movement of the contents through the intestine stops) and mechanical intestinal obstruction (in this case, mechanical blockage of the intestine occurs at some level). nine0003

Mechanical obstruction is much more common and can develop due to blockage of the intestine by a foreign body, tumor, feces, as well as due to compression or infringement of the intestine from the outside during adhesions in the abdominal cavity, volvulus or formation of nodes. Dynamic intestinal obstruction can develop with diffuse peritonitis of any etiology, with long-term biliary or renal colic, after surgery on the abdominal organs, in case of poisoning with salts of heavy metals, as well as injuries and tumors of the brain and spinal cord (when the innervation of the intestinal wall is disturbed) . nine0003

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Symptoms

  • Severe, cramping or persistent abdominal pain that occurs suddenly, regardless of food intake, and does not have a specific localization.
  • Bloating.
  • Intractable vomiting (the higher the level of obstruction, the more pronounced vomiting). nine0014
  • Retention of stools and gases (with high obstruction, there may first be stool due to bowel emptying below the level of the obstruction).

Diagnostics

Plain radiography, ultrasound of the abdominal organs, MSCT can be performed to confirm the diagnosis.

If signs of intestinal obstruction are detected, to clarify the localization of the process, radiography is performed with oral administration of a radiopaque substance. A colonoscopy (an endoscopic method for examining the large intestine) and other additional studies may also be performed. nine0003

Treatment

In most cases, urgent surgery is needed.

However, all types of dynamic obstruction are subject to conservative treatment, which includes ensuring the patency of the gastrointestinal tract with the help of enemas, removal of intestinal contents with a nasogastric or nasointestinal tube, correction of water and electrolyte disorders, control of hemodynamics, normalization of peristalsis, detoxification and antibiotic therapy. nine0003

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Our leading specialists

All specialists

Evseev Maxim Alexandrovich

Vladykin Alexey Leonidovich

Alekseev Mikhail Sergeevich

Fedotov Stanislav Viktorovich

Balaryov Anton Sergeevich

Efimkina Jennet Orazmammetovna

nine0002 Zatsarinny Vladimir Viktorovich

Rozumny Ilya Arkadyevich

Titkov Boris Evgenievich

Benefits of the Hospital Center

Individual treatment regimen for each patient

For each patient, on a mandatory basis, even at the pre-hospital stage, an individual treatment regimen is developed, taking into account all the characteristics of the body: age, health status, medical history, etc. – this approach allows minimizing the risks both during the operation and in the postoperative period, and as a result, to ensure the fastest possible rehabilitation with a minimum stay in the hospital. nine0003

Multidisciplinary approach

The medical staff of the Hospital Center is a single team made up of doctors - experts in different specialties, which allows for a multidisciplinary approach. We treat a patient, seeing before us not a list of his diseases, but a person whose problems are interconnected and interdependent. The therapeutic measures taken are always aimed at improving the overall health, well-being and quality of life of the patient, and are not limited to eliminating the symptoms of a particular disease. nine0003

Surgical treatment of any level of complexity

Operating doctors of the Hospital Center have advanced and high-tech methods of performing operations. The combination of highly qualified doctors and innovative equipment allows for surgical treatment of the highest level of complexity.

High-tech, minimally invasive methods of treatment

The basis of the treatment methodology carried out at the Hospital Center is the principles of minimizing risks for the patient and the fastest possible rehabilitation. nine0003

The implementation of this approach is possible only with the use of the most high-tech techniques, modern equipment and the latest achievements of medical science.

The qualifications of doctors, combined with modern equipment, allows us to successfully implement this approach to treatment.

Fast-track surgery

Fast-track is a comprehensive technique that allows you to minimize the length of the patient's stay in the hospital without compromising the quality of treatment. nine0003

The approach is based on minimizing surgical trauma, reducing the risk of postoperative complications and accelerated recovery after surgical operations, which provides our patients with a minimum hospital stay.

Even complex operations such as cholecystectomy, thanks to this approach, require a hospital stay of no more than 3 days.

Personal medical supervision in the postoperative period

To completely exclude the development of possible complications, all patients, regardless of the complexity of the operation, spend the early postoperative period in the intensive care unit under the individual supervision of a resuscitator. nine0003

The transfer of the patient to the ward is carried out only in the absence of even the smallest possible risks.

Informing relatives 24/7

We are as open as possible and take care not only about the patient, but also about his relatives. Information about the health status of patients is provided to relatives seven days a week, 24 hours a day.

Visiting patients is also possible at any convenient time.

Highly comfortable single and double rooms

Patients are offered spacious, comfortable rooms for single and double occupancy, equipped with everything necessary for rest and recovery.

In the children's department, our little patients are accommodated together with their parents.

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