Materiały źródłowe

• #1 Intussusception – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intussusception/diagnosis-treatment/drc-20351457

  Treatment of intussusception typically happens as a medical emergency. Emergency medical care is required to avoid severe dehydration and shock, as well as prevent infection that can occur when a portion of intestine dies due to lack of blood. […] Treatment options for intussusception may include: […] A water soluble contrast or air enema. This is both a diagnostic procedure and a treatment. If an enema works, further treatment is usually not necessary. This treatment can actually fix intussusception 90% of the time in children, and no further treatment is needed. If the intestine is torn (perforated), this procedure can’t be used. […] Intussusception recurs up to 20% of the time, and the treatment will have to be repeated. It is important that a surgeon be consulted even if treatment with enema is planned. This is because of the small risk of a tear or rupture of the bowel with this therapy.

• #1 Intussusception – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intussusception/diagnosis-treatment/drc-20351457

  Surgery. If the intestine is torn, if an enema is unsuccessful in correcting the problem or if a lead point is the cause, surgery is necessary. The surgeon will free the portion of the intestine that is trapped, clear the obstruction and, if necessary, remove any of the intestinal tissue that has died. Surgery is the main treatment for adults and for people who are acutely ill.

• #2 Intussusception – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intussusception/symptoms-causes/syc-20351452

  Intussusception is a rare, serious disorder in which one part of the intestine slides inside an adjacent part. […] In children, the intestines can usually be pushed back into position with a minor procedure. In adults, surgery is often required to correct the problem. […] Intussusception requires emergency medical care. If you or your child develops the symptoms listed above, seek medical help right away. […] In adults, intussusception is usually the result of a medical condition or procedure, including: A polyp or tumor. […] Intussusception can cut off the blood supply to the affected portion of the intestine. If left untreated, lack of blood causes tissue of the intestinal wall to die. Tissue death can lead to a tear in the intestinal wall, called a perforation. This can cause an infection of the lining of the abdominal cavity, known as peritonitis. […] Peritonitis is a life-threatening condition that requires immediate medical attention.

• #3 Therapeutic Enema for Intussusception

  https://www.radiologyinfo.org/en/info/intussusception

  Doctors may perform a therapeutic enema to avoid surgery. The enema uses air or a contrast material solution to create pressure within the intestine and „un-telescope” the intussusception while relieving the obstruction. […] The doctor may use abdominal ultrasound or an enema to help identify and diagnose an intussusception. They may also use the enema to treat the intussusception, in which case it is referred to as a therapeutic enema. […] The therapeutic enema is not always successful. Your child may need surgery to correct the problem. […] Doctors use therapeutic enema to treat symptoms of intussusception, including abdominal swelling or distention, severe abdominal pain that comes and goes, vomiting, and passing stools mixed with blood and mucus. […] An air-contrast or liquid-contrast enema may not successfully unfold the segments of the intestine. Some children may be too ill to undergo the procedure. In these cases, your child may need surgery to treat intussusception.

• #4 Intussusception Treatment & Management: Approach Considerations, Nonoperative Reduction, Surgical Reduction

  https://emedicine.medscape.com/article/930708-treatment

  The presence of peritonitis and any evidence of perforation revealed on plain radiographs are the only 2 absolute contraindications to an attempt at nonoperative reduction with a therapeutic enema. […] Therapeutic enemas can be hydrostatic, with either barium or water-soluble contrast, or pneumatic, with air insufflation. […] Enema reduction is more likely to be successful if initiated early (eg, within 4 hours of hospitalization). […] A study by Flaum et al presented their experience in intussusception reductions using saline enema under ultrasound control and concluded that it is an efficient and safe procedure. […] When performing a therapeutic enema, the recommended pressure of air insufflation should not exceed 120 cm of water. When using barium or water-soluble contrast, the column of contrast should not exceed 100 cm above the level of the buttocks.

• #4 Intussusception Treatment & Management: Approach Considerations, Nonoperative Reduction, Surgical Reduction

  https://emedicine.medscape.com/article/930708-treatment

  If nonoperative reduction is unsuccessful or if obvious perforation is present, promptly refer the infant for surgical care. […] Traditional entry into the abdomen is through a right paraumbilical incision. Deliver the intussusception into the wound and attempt nonoperative reduction. […] Laparoscopy has been added to the surgical armamentarium in the treatment of intussusception. […] Laparoscopy is associated with faster recovery times, decreased length of stay, decreased time to full feeds, and lower requirements of pain medication. […] With toleration of diet, patients treated with nonoperative reduction are usually discharged 12-18 hours after the therapeutic enema. […] Involve a pediatric surgeon as early as possible to help coordinate the care and resuscitation of the child. The availability of a pediatric radiologist enhances the chances of successful nonoperative reduction.

• #5 Intussusception (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/intussusception.html

  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.

• #5 Intussusception (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/intussusception.html

  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.

• #6 Pediatric Intussusception Surgery Treatment & Management: Approach Considerations, Nonoperative Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/937730-treatment

  Since the first use of barium enema as a diagnostic tool in 1913, enemas with air, barium, or other fluid have become a mainstay not only of diagnosis but also of therapy, replacing surgery as the initial management of stable patients. At present, the two most commonly used enema methods for reduction of pediatric intussusception are as follows: Ultrasonography (US)-guided hydrostatic reduction (UGHR) and Fluoroscopy-guided air reduction (FGAR). […] The diagnostic enema is therapeutic in 80-90% of patients. Thus, treatment is usually concluded in the radiology suite, and some surgeons elect to observe these patients in the hospital until they can tolerate an oral diet. […] A successful therapeutic reduction must demonstrate free flow of contrast (air or barium series) proximal to the ileocecal valve.

• #6 Pediatric Intussusception Surgery Treatment & Management: Approach Considerations, Nonoperative Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/937730-treatment

  If manual reduction is unsuccessful, if a mass or pathologic lead point is present, or if perforation has occurred, segmental bowel resection is necessary. […] Laparoscopy in the management of intussusception was initially limited to a diagnostic role. It was used to confirm unreduced bowel following an enema, with prompt conversion to an open procedure. […] The role of laparoscopy in pediatric intussusception is evolving and will continue to be refined as technology progresses and experience with the minimally invasive approach to this disease grows. […] IV fluid resuscitation is continued and calculated, with consideration given to maintenance requirements and third-space losses. Upon resolution of ileus, diet is advanced at the discretion of the surgeon. […] Intussusception results in bowel obstruction; thus, complications such as dehydration and aspiration from emesis can occur. Ischemia and bowel necrosis can cause bowel perforation and sepsis.

• #7 Intussusception: What It Is, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10793-intussusception

  Intussusception requires emergency care but its treatable if you get help fast. […] Treatment involves using an air or contrast enema (the same procedure used for diagnosis) to straighten out the telescoping in your childs intestine. This is a radiologic (imaging) procedure, not a surgical one, so your child wont need anesthesia. […] Adults with intussusception need surgery, and (less often) so do some children. For example, if the enema doesnt work or your child has a complication (like a bowel tear or an infection), theyll need surgery. […] The procedure may be a traditional open surgery, which involves one large cut in the abdomen. Or, the surgeon may use a less invasive procedure called laparoscopy. […] During a laparoscopy, a surgeon makes two or three small incisions (cuts) into your childs abdomen. These cuts allow a surgeon to access the telescoped intestine and position it into place. If repositioning isnt possible, theyll remove the involved segment of intestine and suture the remaining (non-telescoped) parts together. […] A barium or air enema is successful in up to 85% of children treated in hospitals where providers have experience treating intussusception. You can improve your childs chances of survival (with no complications) by getting them diagnosed and treated as soon as you notice symptoms.

• #8 Current diagnosis and image-guided reduction for intussusception in children

  https://www.e-cep.org/journal/view.php?doi=10.3345/cep.2021.01816

  Among them, pneumatic reduction under fluoroscopic guidance is the most widely used. […] The basic principle of enema reduction is to move back the intussusception through the ileocecal valve by the intracolonic pressure of the reduction medium regardless of type. […] Hydrostatic enema reduction (commonly using saline) under ultrasonographic guidance has been increasingly used based on comparable success rates of 73%86% and low perforation rate (1%) by experienced providers, which has the advantage of avoiding radiation exposure. […] Nonoperative reduction is generally unsuccessful in the treatment of small bowel intussusception, and enema reduction is not recommended except in certain conditions of concomitant ileocolic or ileoileal intussusception occurring near the ileocecal valve.

• #8 Current diagnosis and image-guided reduction for intussusception in children

  https://www.e-cep.org/journal/view.php?doi=10.3345/cep.2021.01816

  Surgical reduction is warranted for persistent small bowel intussusception in symptomatic patients, and focal lead points are often observed in such cases. […] Nonoperative enema reduction is effective for children without contraindications, and a recent meta-analysis of more than 40,000 cases reported a pooled success rate of 82%. […] Surgical management is indicated for children with recurrent intussusception if it is irreducible by enema reduction or pathologic lead points are documented through imaging studies. […] The rare but most important complication of enema reduction, bowel perforation, is reported in approximately 0.4% of cases of air and liquid enemas. […] Successful enema reduction is less likely to be achieved in children with a longer symptom duration before presentation, younger age, unfavorable symptoms (lethargy, bloody diarrhea), radiologic findings (small bowel obstruction, trapped fluid between the intussusceptum and intussusceptor, ascites, or absence of flow in the intussusception), pathological lead points, and distant location of the intussusception.

• #9 Management of intussusception in children | Cochrane

  https://www.cochrane.org/CD006476/COLOCA_management-intussusception-children

  Once intussusception is diagnosed, most doctors agree on the use of enema as initial treatment. This procedure involves introducing a substance (air or liquid) into the bowel, via the rectum, with a particular pressure that reduces the 'telescoped’ bowel into its normal position. […] Evidence from two studies suggests that using air for the enema to reduce intussusception is superior to using liquid for the enema. Evidence from two studies also suggests that giving the child with intussusception a steroid medication, such as dexamethasone, may reduce the recurrence of intussusception, irrespective of whether liquid or air is used for the enema. […] Air enema may be more successful than liquid enema for reducing intussusception. This equates to a number needed to treat for an additional beneficial outcome of 6 (95% CI 4 to 19).

• #10 Intestinal Intussusception: Etiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5179276/

  Intussusception is defined as the invagination of one segment of the bowel into an immediately adjacent segment of the bowel. […] In the adult population, intussusception is frequently due to a pathologic lead point, which can be intraluminal, mural, or extramural. As opposed to the pediatric population, the treatment of intussusception causing obstruction in adults typically involves surgery, often with bowel resection. […] In the pediatric population, treatment depends on the type of intussusception. Ileocolic intussusception, the most common type in children, requires reduction by ultrasound-guided or fluoroscopic pneumatic or hydrostatic enema, and is successful in 85 to 90% of cases. […] Surgery is required if there are signs of bowel necrosis. Historically, adult intussusceptions have been treated surgically due to the association of pathology serving as lead point.

• #11 Intussusception in Adults: Causes, Symptoms & Treatment

  https://patient.info/doctor/intussusception-in-adults

  There is much debate as to the best management of intussusception in adults. […] Historically, surgical treatment was the mainstay of treatment for adult intussusception, due to the higher risk of pathology such as malignancies serving as the lead point. […] However, with the widespread use of CT scanning, many cases of transient intussusception in adults have been observed that have caused few, if any, symptoms – especially in conditions that alter GI tract motility. […] Intraoperative reduction before resection has also been attempted but the success rates are rather disappointing and there are concerns that this can lead to intraluminal seeding of malignant cells, perforation and increased risk of complications at the site of anastomoses, due to oedema of the bowel. […] Reduction of the intussuscepted bowel is considered safe for benign lesions in order to limit the extent of resection or to avoid short bowel syndrome. […] One recommendation is that all intussusceptions involving the large bowel should be resected, as there is an almost 60% risk of malignancy, whereas small bowel intussusceptions should be managed by reduction initially, as the risk of a neoplastic lesion is much less.

• #12 Intussusception | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/intussusception

  Intussusception is not usually immediately life-threatening. It can be treated with either a water-soluble contrast enema or an air-contrast enema, which both confirms the diagnosis of an intussusception, and in most cases successfully reduces it. […] An enema is done by placing a small tube into the rectum. Fluid or air is gradually added into the tube to allow clinicians to see the intussusception that is blocking the intestine via X-ray or ultrasound. […] The pressure of the fluid or air pushes the telescoping bowel back to its normal position, fixing the problem. […] Most of the time the enema will take care of the bowel problem. However, in 10-15 percent of cases, the bowel cannot be reduced and surgery is necessary. […] In a reduction of the bowel surgery, the surgeon may choose to do the procedure with one larger incision (called an open procedure) or laparoscopically, with tiny incisions and a camera.

• #13 Intussusception | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/intussusception

  Whether open surgery or laparoscopic, the intussusception is carefully reduced by gently pushing the leading portion of the intussusceptions back upstream to reduce the telescoping of the bowel. […] If the surgeon is unable to successfully reduce the bowel, then the afflicted section will need to be removed. When this happens, the surgeon must remove the affected part of the intestine and sew the two healthy sections back together.

• #14 Laparoscopic Intussusception What to Expect | WakeMed

  https://www.wakemed.org/care-and-services/childrens-services/services-and-specialties/surgery/intussusception/laparoscopic-intussusception-what-to-expect

  Your child will be given a general anesthesia and will remain asleep throughout the surgery. Using a series of small incisions, the pediatric surgeon inserts a tiny laparoscope that clearly visualizes the abdomen. Once the obstruction has been located, the intussusception is reduced by carefully tucking it back into its normal position. In rare cases, the surgeon may not be able to push the bowel back into place. When this occurs, the affected portion of the bowel is removed and the healthy segments are sutured together. […] Most children feel better within the first week, but it takes a month to fully recovery. Your childs pediatric surgeon will advise on what sort of activities to avoid and how to take precautions.

• #15 The Management of Intussusception: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10752083/

  In clinically appropriate situations, it is advisable to consider repeated attempts at enema reductions. […] Laparoscopic reduction demonstrates consistently high success rates. […] In the case of intussusception in pediatric patients who are hemodynamically stable and lack serious illness, pre-reduction antibiotics may not be necessary. […] The optimal course of action is to emphasize nonoperative outpatient therapy. […] Colonic intussusception should be removed in one piece, whereas enteric intussusception can be treated via reduction and then resection. […] The standard treatment for adult intussusception is still surgery.

• #15 The Management of Intussusception: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10752083/

  It is essential to note that the prevailing treatment for adult intussusception remains to be surgical intervention. […] The literature review on managing intussusception in children highlights the need to refrain from administering antibiotics prior to reduction, utilize minimally invasive surgical procedures as the primary operative approach, and repeat radiologic reduction attempts to minimize the necessity for surgery. […] A management algorithm developed during the evaluation should only be used on children who are healthy and do not have a life-threatening illness. […] Following enema reduction, outpatient care for intussusception resulted in a shorter hospital stay without impacting mortality, recurrence, or the rate of readmission to the emergency room. […] The findings suggest that the use of preventive antibiotics does not alleviate issues following radiologic reduction.

• #16

  https://journals.lww.com/jcge/fulltext/2003/01000/the_diagnosis_and_treatment_of_adult.7.aspx

  Recently, several reports have recommended a selective approach to resection. […] In cases in which the bowel is inflamed, ischemic, or friable, it is advisable not to attempt operative reduction but to proceed directly with resection. […] In most cases of ileocolic, ileocecocolic, and colocolic intussusception, primary resection without reduction should be performed, especially in patients more than 60 years of age because of the high incidence of malignancy. […] In patients with small bowel intussusception, reduction should always be initially attempted unless signs of bowel ischemia or inflammation are present or a malignancy is not suspected.

• #17 Intussusception in children – UpToDate

  https://www.uptodate.com/contents/intussusception-in-children

  Nonoperative reduction using hydrostatic or pneumatic pressure by enema is the treatment of choice for an infant or child with ileocolic intussusception who is clinically stable and has no evidence of bowel perforation or shock, when appropriate radiologic facilities are available. […] Nonoperative reduction can be guided by fluoroscopy or ultrasound, and either pneumatic or hydrostatic enemas may be used. […] Surgical treatment is indicated as a primary intervention for patients with suspected intussusception who are acutely ill or have evidence of perforation. […] Surgery is also indicated when imaging reveals a persistent focal filling defect, indicating a mass lesion. […] Contemporary operative management of childhood intussusception by pediatric surgeons uses a minimally invasive approach via laparoscopy in most cases.

• #18 Intussusception: Symptoms, Causes, Diagnosis & Treatment

  https://www.healthline.com/health/intussusception

  Intussusception requires emergency medical care. […] The severity of intussusception is one of the key factors in determining its treatment. Your child’s age and general health are also important. Doctors will typically consider nonsurgical treatment methods first. […] A barium saline or pneumatic pressure enema may be sufficient for treating intussusception. This procedure starts with the injection of air into the intestine. The pressure from the air may push the affected tissue back into its original position. […] As explained in a 2017 journal article, nonsurgical methods have an approximate 85 to 90 percent success rate in children. […] If an enema is ineffective or there are signs of bowel necrosis (death of the tissue), surgery may be necessary. […] Surgery is the primary approach for adults with intussusception and children who are very ill with the condition. […] In young children, nonsurgical treatments may be enough to treat it effectively. However, surgical options are also available for treating intussusception.

• #19 The clinical study on conservative therapy of pediatric intussusception: caudal block improves the success rate – Kim – Art of Surgery

  https://aos.amegroups.org/article/view/6323/html

  Conclusions: Caudal block in combination with intramuscular ketamine is very effective one that can raise the success rate (93.9%) for repair as well as shorten repair times and necessary time. […] Caudal block in combination with sedation can improve the condition for reduction of intussusception by providing sufficient muscle relaxation. […] The caudal block in combination with ketamine improved the success rate (approximately 93.9%) of reduction of intussusception and shorten the necessary time for reduction as well as did not affect a negative effect on the hemodynamic and respiratory function.

• #20 Bowel intussusception in adult: Prevalence, diagnostic tools and therapy

  https://www.wjgnet.com/2222-0682/full/v11/i3/81.htm

  On the other side, many reports suggest a wait and see strategy, with serial clinic and imaging evaluation to ensure spontaneous resolution in entero-enteric intussusceptions without lead point mass and short affected segment (3.5 cm). […] Undoubtedly, other controversy remains as to whether reduction of the intussusception should be attempted intraoperatively. […] The choice of preforming laparoscopic rather than open procedure depends both on the clinical condition of the patient and on surgeons laparoscopic experience. […] The management of bowel intussusception in adult remains mainly surgical. The timing and type of approach depends on several factors such as the underlying causes, the severity of clinical presentation, the site and the length and vitality of the bowel segment involved.

• #21 Adult Intussusception: Diagnosis and Treatment.

  https://coloproctol.org/journal/view.php?doi=10.3393/jksc.2007.23.6.416

  Adult intussusception occurs infrequently and differs greatly from childhood intussusception in etiology. Proper diagnostic of and surgical therapeutic methods for adult intussusception remain controversial. The aim of this study was to determine useful diagnostic modalities and proper surgical interventions in adult intussusception. […] Both ultrasonography and abdominal computerized tomography are the most useful diagnostic modalities. Colonic intussusception should be treated with en-bloc resection without reduction due to the high incidence of malignancy. However, manual reduction only, bowel resection after reduction, and bowel resection alone can be chosen selectively in cases of small bowel intussusception.

• #22 Treatment of adult idiopathic ileocolic intussusception with non-operative reduction under fluoroscopic guidance

  https://www.oatext.com/Treatment-of-adult-idiopathic-ileocolic-intussusception-with-non-operative-reduction-under-fluoroscopic-guidance.php

  Intestinal intussusception is rare in adults, often associated with a malignant lesion and usually requires surgery. Preoperative diagnosis is best made using an abdominal CT scan. Unlike in pediatric cases, non-operative reduction using contrast enema or air is not often employed. However for benign or idiopathic cases, reduction can be attempted before electing for surgery. […] Non-operative reduction using contrast enema was performed under fluoroscopic guidance. […] Non-operative reduction can be attempted when the lead point is thought to be benign or unclear (idiopathic). […] In conclusion, we reported a case of adult idiopathic ileocolic intussusception which was successfully treated with non-operative reduction under fluoroscopic guidance.

• #23 Intussusception | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/intussusception/

  After treatment, either with an air enema or surgery, there is a chance that the intussusception will happen again. In our experience, this happens in about five children in every 100, but is more likely in the first few days after treatment. If a child develops intussusception again, it can be treated in the same way as before. […] The child will come back to the ward to recover where we will monitor them closely. They may be connected to monitors to check their breathing, heart rate and oxygen levels. They will have been given pain relief during the operation, but this will begin to wear off. For the first few days, pain relief will usually be given through a drip and then, when the child is more comfortable, in the form of medicines to be swallowed. […] The child will not be able to feed initially to allow the bowel to recover. They will continue to have a drip of fluids and the nasogastric tube to drain off the stomach contents. As they begin to recover, usually in the first couple of days, the child will be able to feed again, starting with small amounts and increasing the amount as tolerated. When the bowel has recovered completely, they will be able to be fed solids. The doctors will advise when this is likely. […] The child will be able to go home once they are feeding well. This is usually a week or so after the operation.

• #23 Intussusception | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/intussusception/

  Intussusception can cause reduced blood flow to the affected part of the bowel, which stops it functioning properly, and bruising and damage to the bowel tissue. The effects of intussusception, such as dehydration due to vomiting, can become serious quite quickly in children, so the condition needs emergency treatment. […] If a child is dehydrated, they will need a drip of fluids for a while before treatment starts. A child may also need a nasogastric tube, which is passed up the nose, down the foodpipe and into the stomach. This will drain off the stomach and bowel contents, and vent any air that has built up, which will make the child more comfortable. The child will also be given antibiotics before treatment starts to reduce the chance of infection. […] An air enema is usually the first treatment. In the X-ray department, a tube is passed into the child’s bottom and air is released into the bowel. This works by pushing the bowel back, so that the intussusception corrects itself. This is monitored using X-rays. If the enema works well, they will be able to return home once they are well and feeding normally.

• #24 What Is Intussusception?

  https://www.webmd.com/a-to-z-guides/what-is-intussusception

  Some cases of intussusception are temporary and don’t need treatment. If an enema doesn’t fix the intussusception, surgery is the next step. […] During surgery: A pediatric anesthesiologist (a specialist in pain relief and sedation in children) will put your child fully to sleep. If the surgery uses laparoscopy, the doctor will make small cuts in the belly and insert small instruments and a camera. Otherwise, the doctor will make a small cut in the right side of the belly and push the intestine back into its normal position. If the doctor isn’t able to fix the intussusception, they’ll remove that part of the bowel. […] In one out of every 10 cases, intussusception returns within 72 hours of the procedure. Whether the treatment was an enema or surgery, your child will stay in the hospital overnight in case it happens again. If an enema did the trick, expect the following: Air will continue to pass out of your child’s body in the hours following the enema. Acetaminophen may be given for fever. No food or liquids will be given for the first 12 hours — after that, clear liquids first, then solid food will be given.

• #25 Intussusception Symptoms, Treatment, Surgery, Diet, Success

  https://www.emedicinehealth.com/intussusception_in_babies_children_and_adults/article_em.htm

  After surgery for intussusception you should eat a regular diet with a variety of healthy foods. […] In about 10% of cases, intussusception returns within 72 hours after a procedure, regardless of whether it was an enema or surgery. […] Complications of intussusception if it is not treated include injury or death of the intestine which can result in surgical removal of the bowel, life-threatening infection (sepsis), and death.

• #26 Intussusception Treatment, Causes, Diagnosis, Symptoms, Stool

  https://www.medicinenet.com/intussusception/article.htm

  Is it necessary to operate when there is intussusception? The treatment of intussusception may or may not require surgery. In some cases, the intestinal obstruction can be reversed with an enema. The enema carries a risk of intestinal rupture and cannot be done if the bowel has already perforated. The procedure also requires the availability of a surgeon, in case the patient’s bowel ruptures or the intussusception cannot be reduced. […] If an enema cannot reverse the intestinal obstruction, surgery is necessary to change the intussusception and relieve the obstruction. If a portion of the intestine has become gangrenous, it must be removed. After surgery, intravenous feeding and fluids are continued until regular bowel movements resume. […] The outlook for intussusception is usually good with early diagnosis and treatment. Early detection and treatment are paramount. […] Early diagnosis and treatment of intussusception are essential to prevent injury to the intestine and the associated sequelae, including surgical bowel removal, sepsis, and even death.

• #27 Intussusception | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/intussusception/

  Intussusception is a life-threatening illness and if left untreated, can cause serious damage to the intestines as their blood supply becomes cut off. […] Specific treatment for intussusception will be recommended by your child’s physician based on the following: […] Surgery will be necessary for intussusception that does not resolve with an enema or for those who are too ill to have this diagnostic procedure. Under anesthesia, the surgeon will make an incision in the abdomen, locate the intussusception and push the „telescoped” sections back into place. The intestine will be examined for damage, and if any sections are not working correctly, they will be removed and the two sections of healthy intestine will be sewn back together. […] If not treated, intussusception is a life-threatening disorder. If treated within 24 hours, most babies recover completely. The long-term outlook depends on the extent, if any, of intestinal damage.

• #28 Epidemiology, clinical characteristics, and treatment of children with acute intussusception: a case series | BMC Pediatrics | Full Text

  https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-03961-y

  A total of 402 infants/children were included (301 males and 101 females) with a mean age of 2.41.5 years (2 months to 9 years). […] Air enema reduction was performed in 344 cases: 335 (97.3%) were successful. […] Air enema reduction is an effective treatment. […] Phloroglucinol is a smooth muscle relaxant that can relax intestinal smooth muscle and relieve intestinal spasms caused by intussusception. […] Phloroglucinol might also be considered. […] The application of phloroglucinol in treating children with acute intussusception is simple and feasible, which can reduce children’s resistance to air enema and is also easily accepted by the parents. […] This study preliminarily suggests the feasibility of phloroglucinol for treating acute intussusception. […] The relaxation of the intestine could also be conducive to improving the efficacy of air enema.

• #29 Intussusception in Children: Causes, Symptoms, and Treatment

  https://patient.info/doctor/intussusception-in-children

  Intussusception treatment and management: Any child with possible intussusception or other serious cause of abdominal pain should be referred urgently to hospital for further assessment. […] Early diagnosis reduces the need for open surgery. […] Resuscitation – 'drip and suck’ – nasogastric tube and IV fluids. […] Use of prophylactic antibiotics does not reduce post-reduction infection rates. […] Radiological methods are used to diagnose in 95% cases (outside Africa): Repeated enema reductions (eg, three tries for three minutes each) are acceptable if clinically appropriate – ie if there is no sign of peritonitis, perforation or shock. […] Air enema 120 mm Hg of pressure or barium enema may be superior to liquid enema. […] The choice of enema is usually left to the radiologist (many now favour air enema).

• #30 Intussusception in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/i/intussusception.html

  Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. […] Sometimes intussusception will repair itself while a child has a barium enema. In many cases, the healthcare provider can correct the problem by giving an air enema or saline enema. This is done by placing a small tube in your child’s rectum. The healthcare provider uses ultrasound or X-rays (fluoroscope) to help place the tube. Air is inserted in the tube. The air may help move the intestine back into its normal position. But if your child is very ill with an abdominal infection or other problems, the provider may choose not to do this. […] Your child will need surgery if the intussusception is not repaired with a barium enema. Your child will also need surgery if they are too ill to have a barium enema, saline enema, or air enema. For the surgery, your child will be given anesthesia so they may comfortably sleep during the procedure. The surgeon will make a cut (incision) in the belly. The surgeon will find the intussusception and push the parts of the intestine back into place. The intestine will be checked for damage. If any sections are not working correctly, they will be removed.

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