Intussusception: Symptoms, Diagnosis & Treatments
Intussusception in children accounts for a large part of the abdominal emergency. Intussusception usually exhibits three distinct symptoms. 1. periodic abdominal pain, 2. grape jam-colored stool, 3. abdominal mass. Because of the history of intussusception in the above case, intussusception can be recognized immediately after complaining of abdominal pain. However, when the patient complains acute abdominal pain like the above case, characteristic symptoms appear Because of this, the diagnosis of intussusception may be delayed or missed. Therefore, when a child complains of abdominal pain or visits a child with vomiting, he should always be suspicious of intussusception.
About 90% of intussusception is idiopathic intussusception with unknown cause. In this case there is a preceding viral infection and lymphoid hyperplasia is observed. Other than this, intussusception has a pathological lead point. Meckel diverticulum is the most common cause of intussusception, and lymphoma and intestinal polyps also cause intussusception.
As mentioned above, intussusception is difficult to suspect when there are nonspecific symptoms or signs. The most important clue is that the mass on the right upper abdomen is touched. Since the mass is touched when the intestine is superimposed, intussusception should always be suspected when the mass is touched, even if there are no characteristic symptoms. Also, even if the long sounds are not abnormal, intussusception can not be completely ruled out. In addition to the three major symptoms of intussusception, intussusception may cause vomiting and diarrhea due to gastroenteritis, changes in mental status, sepsis, shock, and syncope.
Because of the difficulty in diagnosing it with clinical features, diagnostic tools are needed. Although X-ray film radiography is used, it is usually normal at the beginning of the onset, so ultrasound is usually used for more accurate diagnosis. If a donut-like lesion is found on ultrasound, it can be diagnosed as intussusception, which has very high sensitivity and specificity. However, because of its operator-dependent nature, the diagnosis may differ depending on the operator's experience and skill. If ultrasonographic diagnosis is difficult, ultrasound reconstruction can be performed and diagnosed and treated. In the case of intussusception due to a mysterious cause, abdominal CT can also be taken to find the lead point. In this case, we could not find any special lead point, so we can think of it as idiopathic. In this case, it is difficult to treat the underlying cause and it is inconvenient to perform decompression every time of recurrence.
Reduction is performed to treat Intussusception. There are Barium enema and Air enema, air enema is known to be safer and more successful. In addition, enema is difficult to perform if there is intestinal perforation or peritonitis. In this case, operative reduction should be performed to correct intussusception.
Intussusception is a very serious emergency in pediatric patients, and delayed diagnosis is associated with many risks, so it is important to always suspicion in children even if they present with nonspecific symptoms other than characteristic symptoms.
About 90% of intussusception is idiopathic intussusception with unknown cause. In this case there is a preceding viral infection and lymphoid hyperplasia is observed. Other than this, intussusception has a pathological lead point. Meckel diverticulum is the most common cause of intussusception, and lymphoma and intestinal polyps also cause intussusception.
As mentioned above, intussusception is difficult to suspect when there are nonspecific symptoms or signs. The most important clue is that the mass on the right upper abdomen is touched. Since the mass is touched when the intestine is superimposed, intussusception should always be suspected when the mass is touched, even if there are no characteristic symptoms. Also, even if the long sounds are not abnormal, intussusception can not be completely ruled out. In addition to the three major symptoms of intussusception, intussusception may cause vomiting and diarrhea due to gastroenteritis, changes in mental status, sepsis, shock, and syncope.
Because of the difficulty in diagnosing it with clinical features, diagnostic tools are needed. Although X-ray film radiography is used, it is usually normal at the beginning of the onset, so ultrasound is usually used for more accurate diagnosis. If a donut-like lesion is found on ultrasound, it can be diagnosed as intussusception, which has very high sensitivity and specificity. However, because of its operator-dependent nature, the diagnosis may differ depending on the operator's experience and skill. If ultrasonographic diagnosis is difficult, ultrasound reconstruction can be performed and diagnosed and treated. In the case of intussusception due to a mysterious cause, abdominal CT can also be taken to find the lead point. In this case, we could not find any special lead point, so we can think of it as idiopathic. In this case, it is difficult to treat the underlying cause and it is inconvenient to perform decompression every time of recurrence.
Reduction is performed to treat Intussusception. There are Barium enema and Air enema, air enema is known to be safer and more successful. In addition, enema is difficult to perform if there is intestinal perforation or peritonitis. In this case, operative reduction should be performed to correct intussusception.
Intussusception is a very serious emergency in pediatric patients, and delayed diagnosis is associated with many risks, so it is important to always suspicion in children even if they present with nonspecific symptoms other than characteristic symptoms.
