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Gastrointestinal medical emergencies

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Intussusception  The loss of perfusion to an area of the intestine because the affected part of the intestine slides into another part of the intestine near the affected area  most commonly, occurs in infants aged 5-10 months.  most common cause of intestinal obstruction in patients ag...

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  • May 16, 2024
  • 12
  • 2023/2024
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Gastrointestinal medical emergencies

Intussusception
 The loss of perfusion to an area of the intestine because the affected part of the intestin
of the intestine near the affected area
 most commonly, occurs in infants aged 5-10 months.

 most common cause of intestinal obstruction in patients aged 5 months to 3 years.

Signs and Symptoms:

 Abdominal pain. In rare circumstances, the parents report 1 or more previous
pain within 10 days to 6 months prior to the current episode; pain in intussus
severe, and intermittent.
 Knee to chest posturing,


 Vomiting. Initially, vomiting is nonbilious and reflexive, but when the intestinal
vomiting becomes bilious.
 Currant jelly stool. Parents also report the passage of stools that look like curra
mixture of mucus, sloughed mucosa, and shed blood or bloody stool


 Lethargy. Lethargy is a relatively common presenting symptom with intussusce
lethargy occurs is unknown because lethargy has not been described with other
obstruction.


 fever

 constipation,

 diarrhea.

Causes
 Hyperperistalsis. The normal wave-like contractions of the intestine grab thi
and the lining of the intestine into the bowel ahead of it.
 Digestive system activities. The unusual mobility of the cecum and ileum norm
life may also cause intussusception.

, 2

ultrasonography should be used as a first-line examination for the assessment o
intussusception.
 CT scanning. Computed tomography (CT) scanning has also been proposed as
diagnose intussusception; however, CT scan findings are unreliable, and CT scan
associated with intravenous contrast administration, radiation exposure, and s
 Contrast enema. The traditional and most reliable way to make the diagnosi
children is to obtain a contrast enema (either barium or air); contrast enema i
and has the potential to be therapeutic.

Note

Palpable sausage mass in the right upper quadrant


Interventions and Treatments:

 Intravenous fluid. For all children, start intravenous fluid resuscitation and n
decompression as soon as possible.
 Therapeutic enema. Therapeutic enemas can be hydrostatic, with either bari
contrast, or pneumatic, with air insufflation; therapeutic enemas can be perfor
fluoroscopic or ultrasonographic guidance; the technique chosen is not importan
radiologist performing the enema is comfortable with the method.
 Surgical reduction. If a nonoperative reduction is unsuccessful or if obvious pe
promptly refer the infant for surgical care; risk of recurrence of the intussuscep
reduction is less than 5%.
 Laparoscopy.
 the surgical armamentarium in the treatment of intussusception;
 performed in all cases of intussusception;
 reduction of the intussusception,
 confirmation of radiologic reduction
 detection of lead points have all been reported.


weight-adjusted intravenous morphine as drug treatment


Nursing assessment

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