Signs of intussusception in children and how to recognize them

The article is professionally consulted by Master, Doctor Truong Thanh Tam - Pediatrician - Pediatrics - Neonatology Department, Vinmec Danang International General Hospital

Intussusception is a common complication in nursing infants, especially those with strong bowel movements. When intussusception, the blood vessels supplying the intestine are blocked, unable to feed the intussusception, which can lead to necrosis. Therefore, parents need to know the signs of intussusception in their children to take them to the emergency room and intervene promptly.

Intussusception is a common surgical emergency in children, occurring when a segment of intestine enters the lumen of an adjacent segment of intestine. The disease can occur at any age but is most common in babies 4-9 months old, especially those who are chubby. Statistics also show that boys have a higher incidence than girls, accounting for 70% of intussusception cases.
At present, the cause of intussusception in children is still unknown. However, there are a number of factors that affect the risk of intussusception in children such as: an imbalance between the size of the ileum compared with the ileocecal valve, mesenteric lymphadenitis, polyps or tumors in the intestines. , intestinal inflammation, intestinal adhesions, intestinal lesions or after respiratory inflammation.
Intussusception obstructs, stagnates food above the intussusception (intestinal obstruction, semi-obstruction). In addition, the intestinal segments are always attached to the nourishing blood vessels, so when intussusception occurs, the blood vessels are also blocked. The blocked intestine will quickly expand, the blood vessels will stagnate, causing the intestine to become ischemic, leading to the process of inflammation, edema, necrosis, and hemorrhage.
Before 48 hours after intussusception, only about 2.5% of the intussusception mass was necrotic. After 72 hours of intussusception, the rate of intussusception necrosis was 80%. Intestinal necrosis due to intussusception will lead to infection, severe toxicity, septic shock, intestinal perforation causing peritonitis, causing death in the child.
If a child with intussusception is brought to the hospital early, the doctor only needs to remove the intussusception with air. If the child is brought to the hospital late or when the air intubation procedure fails, the doctor will choose the appropriate surgical method depending on the situation.

Here are the signs of intussusception in children:
The age at risk of intussusception is 4 - 9 months old, most common in 5-6 months old; Children who are eating normally suddenly cry, stop sucking, stop playing, and turn pale - signaling that the intestines have begun to intertwine. Then the baby temporarily stops crying, even suckling again; When the pain recurs, the child cries intermittently, hunches over, cannot suckle, vomits food or green or yellow fluid; After a few hours, the child is tired, the skin is smooth; After about 6-12 hours, the child passes out fresh blood or brown, with a bit of mucus. Young pale skin, dry lips, rapid pulse, cold body and sunken eyes; If not treated within 24 hours, the child will have continuous vomiting, abdominal distension, cold, pale skin, small and rapid pulse, shallow breathing, little urine, high fever, lethargy, coma , signs of severe dehydration; have manifestations of infection, intoxication, dehydration or septic shock; Touching the baby's abdomen can see the intussusception as a bulge.

When the child cries, refuses to breastfeed, vomits, it is necessary to immediately take the child to the hospital; When determining that the child has intussusception, it is necessary to remove the intussusception by rectal inflation or contrast enema under the guidance of the X-ray projector. Under the pressure of air or medicine, the intussusception will be gradually removed; If the child is brought to the hospital more than 6 hours late, immediate surgery is required to remove the intussusception; In case after 24 hours, the intestine has signs of necrosis, it is necessary to surgically remove that segment of intestine. The care and resuscitation after surgery is also very difficult and complicated, children are easy to die due to exhaustion and severe pneumonia.

Because the real cause of intussusception in children is unknown, there is no specific preventive measure. The best way is for parents to quickly recognize abnormal signs in their children to detect intussusception early and avoid dangerous complications caused by the disease.
When a child shows signs of intermittent abdominal pain, manifested by sudden, intense crying, the child hunches over, stops sucking, twists, stops playing, etc., parents need to immediately take the child to a doctor. . Specialist doctors will quickly examine and do additional paraclinical diagnoses such as blood tests, stool tests, abdominal ultrasound, X-rays, etc. to make a definitive diagnosis and take measures. timely intervention for children.