Ultrasonographic and clinical predictors of intussusception. The painless intussusception. Predictors of intussusception in young children. Arch Pediatr Adolesc Med. Arch Pediatr Adolesc Med link - Pubmed citation 4.
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Analgesia and Sedation Key Points The diagnosis of intussusception requires a high index of suspicion. Consider intussusception in infants and children with intermittent distress, vomiting or isolated unexplained lethargy. Ultrasound is the initial study of choice. Background Intussusception is the invagination telescoping of a proximal segment of bowel into the distal bowel lumen.
The commonest site is a segment of ileum moving into the colon through the ileo-caecal valve. This process leads to bowel obstruction, venous congestion and bowel wall ischaemia. Perforation can occur and lead to peritonitis and shock. It may be profound, episodic or persistent Vomiting is usually a prominent feature but bile stained vomiting is a late sign and indicates a bowel obstruction Diarrhoea is quite common initially and can lead to a misdiagnosis of gastroenteritis.
The abdominal mass may be subtle and examination is best performed when the child is settled in between episodes Abdominal distension suggests bowel obstruction Tenderness or guarding may suggest perforation and peritonitis Inspection of the nappy and perianal region should be done. A rectal examination is rarely indicated Infants may present with Hypovolaemic shock Management Analgesia and resuscitation should precede investigation. Therefore, the enema is performed where paediatric surgery is available in case of the need for laparotomy.
Consider a nasogastric tube on free drainage if transferring by air. Parent information.
INTUSUSCEPCION PEDIATRIA PDF
Differential diagnosis[ edit ] An intussusception has two main differential diagnoses: acute gastroenteritis and rectal prolapse. Abdominal pain, vomiting, and stool with mucus and blood are present in acute gastroenteritis, but diarrhea is the leading symptom. Rectal prolapse can be differentiated by projecting mucosa that can be felt in continuity with the perianal skin, whereas in intussusception the finger may pass indefinitely into the depth of the sulcus. Treatment[ edit ] The condition is not usually immediately life-threatening.
Intussusception (medical disorder)
Small Bowel Intussusception can also lead to intestinal necrosis. These delays are associated with higher complication rates. Obviously it would be best to avoid unnecessary surgery for those that will have spontaneous reduction of their benign small bowel intussusception. Smaller is better. Lead Points are bad. Pay attention to the patient! Transient versus surgically managed small bowel intussusception in children: Role of ultrasound.
Intususcepción En Niños
Faukazahn Radiol Clin North Am ; 41 6: The etiology of these intussusceptions was idiopathic or secondary to a lesion acting as the lead point for invagination. The treatment chosen is the radiological reduction, preferably the air ACE as a contrast way intususcspcion of its low risk in the reduction appellant of up to 10 episodes. The four unoperated patients were followed up for a mean of months range: Do you really want to delete this prezi? A year-old man with a history of HIV infection diagnosed intususccepcion years before, anti-hepatitis C antibodies and inhaled drug abuse was admitted to our hospital with a 20 day history of intermittent abdominal colicky pain, predominantly on the periumbilical region and in the left flank, and fever, night sweats and weight loss 5 kg during. Acute intestinal intussusceptions in adults: Ann Chir ; 8: Surgery is the first-line therapy in complications such as perforation Ann Surg ; Clinical entity and treatment strategies for adult intussusceptions: Clinical spectrum and surgical approach of adult intussusceptions: Surgery is also necessary to obtain a biopsy to establish the diagnosis and to assess the regional extension of the neoplasm. Azar T, Berger DL. However, we observed a substantial difference to other studies, which lies in the nature of lesions.
Small Bowel Intussusception