Table Of Contents

Causes of Intestinal Telescoping in Children

Frequently Asked Questions About Intestinal Intussusception

Intussusception is a condition in infants where one part of the intestine slides inside another, causing blockages. Prompt treatment is essential.

Infant intussusception occurs in the small intestine, which processes food towards the rectum for nutrient absorption and elimination of residual waste. This condition leads to intestinal blockage accompanied by severe pain, prompting us to question how intestinal intussusception occurs in infants, what its causes are, and how intestinal obstruction is treated in children in Turkey.

Intestinal intussusception meaning

Contracting intestinal intussusception is generally prevalent among infants and young children aged 6 months to 3 years, with an incidence rate of approximately one case per 1000 children, according to statistical studies. Consequently, parents must be aware of the symptoms of intestinal intussusception to promptly seek medical attention for their child and manage this condition.

Firstly, we need to understand the term “intussusception”: it refers to the telescopic overlap of a segment of the intestine into the one following it, resulting in the compressed segment, causing its blockage.

Intussusception In Children — Intestinal Obstruction In Intussusception In Infants

Intestinal telescoping in infants typically occurs in the area of the ileocecal junction – the region where the small intestine connects with the large intestine (ileocecal intussusception). The small intestine telescopes into the large intestine, causing compression and resulting in intestinal blockage.

Intussusception of small intestine is one of the most common causes of intestinal obstruction in infants.

In some cases, this compression leads to the interruption of blood supply to the telescoped segment, causing it to necrotize. This can result in serious complications for the child’s life, and symptoms of toxicity may appear due to the deterioration of their health.

Causes of Intestinal Telescoping in Children

Up until now, the fundamental cause of intestinal intussusception in newborns has not been determined, but males are more commonly affected than females.

In any case, the most significant contributing factor to infantile intestinal intussusception is respiratory or digestive infections preceding this telescoping. It is common for the child to have a cold before experiencing intestinal intussusception.

This can be explained by these infections causing swelling in the defensive tissues located in the intestinal wall, leading to variations in wall thickness. When the intestinal wall moves to propel food toward the colon, a thin segment may telescope into the thicker segment following it, resulting in intestinal intussusception.

Lymphomas or certain tumors may also lead to intestinal intussusception in older age groups through the same mechanism. In such cases, broader investigations must be conducted to identify the cause and administer immediate treatment.

Intussusception Symptoms in Children

Intestinal intussusception leads to the emergence of symptoms of intestinal obstruction in infants. The intussusception in infants symptoms include:

Sudden, severe bouts of crying due to intense abdominal pain that may subside and recur.
Abdominal bloating and constipation due to intestinal obstruction.
The infant may experience nausea and frequent vomiting, with the vomit color being green or yellow.
Loss of appetite and refusal to eat.
Intestinal intussusception in infants can result in cherry-red, jelly-like blood in the stool (intussusception jelly stool).
Some children may experience general weakness and an increase in body temperature. If your child exhibits similar symptoms, it is crucial to consult a doctor promptly for a diagnosis and appropriate treatment.

Infant Intussusception In Abdominal Surgery

Diagnosis of Intestinal Intussusception

Intestinal intussusception is considered a serious emergency condition; therefore, all doctors must diagnose it and promptly refer it to a specialist for immediate treatment. In Turkey, doctors rely on the following methods to diagnose intestinal intussusception:

Clinical examination: The doctor palpates the infant’s abdomen, detecting a sausage-like mass, raising suspicion of intussusception. Additionally, the doctor may observe the passage of bloody stool from the child (cherry-red gel-like stool).
Ultrasound imaging (Echo): The doctor requests abdominal ultrasound to reveal the presence of intestinal intussusception. Echo is considered the optimal diagnostic method for intestinal intussusception.
Lower gastrointestinal endoscopy is also an important investigative and therapeutic tool. Through this procedure, the location of the intussusception can be visualized, and attempts can be made to reduce it without resorting to surgery.

Intussusception Treatment in Turkey

The treatment of intestinal intussusception is an emergency, as mentioned earlier. Intestinal intussusception in children cannot be treated at home because it will lead to serious consequences. Instead, it should be treated by a specialized pediatric surgeon.

Surgery is not always necessary to reduce intestinal intussusception; it can sometimes be reduced without opening the abdomen. However, this non-surgical approach depends on specific conditions that must be met for non-surgical procedures to be attempted. Otherwise, surgery is the optimal solution for treating intestinal intussusception.

Non-Surgical Treatment of Intestinal Intussusception

Doctors in Turkey may successfully reduce intestinal intussusception without surgery using lower gastrointestinal endoscopy. This is done with the assistance of X-ray imaging to ensure the success of the reduction procedure. We may use echo or X-rays to view the telescoped area. With lower gastrointestinal endoscopy, we inject special fluids or air, generating sufficient force to push the telescoped portion back to its original position.

The X-ray imaging used confirms the success of the reduction procedure. Subsequently, the symptoms of the child affected by intestinal obstruction improve, and their life returns to its normal state. Unfortunately, the use of this method is subject to certain conditions that must be adhered to, including:

The intussusception occurred within the last 24 hours.
No perforation has occurred in the telescoped intestines (otherwise, surgical intervention is necessary).
The intussusception is not recurrent (reduced without surgery previously and then telescoped again).
The child’s age is between 5-12 months.

If these conditions are not met, conservative reduction may not achieve the desired results, and surgical treatment becomes necessary.

Intestinal Intussusception Surgery

Surgical intervention remains the optimal solution for intestinal intussusception in Turkey when conservative treatment fails to achieve healing for the infant. The surgery is performed under general anesthesia as it involves surgical abdominal incisions.

Initially, the child’s stability is ensured before surgery by monitoring laboratory tests and compensating for lost fluids and electrolytes during the preoperative period. Once the child’s condition stabilizes, they are ready to undergo the surgical procedure.

After the child is anesthetized and the skin is sterilized, the surgeon makes small incisions to access the affected area. The surgeon identifies the site of intestinal intussusception and carefully frees the telescoped portion.

Infant Intussusception Surgery In Türkiye

The surgeon then ensures the vitality of the affected segment. If the telescoped portion has not been harmed due to impaired blood supply, the surgery concludes here. The surgeon closes the incisions, and the child improves immediately after the surgical procedure.

However, if the segment is compromised, it necessitates its removal and reconnection of the intestines, extending the infant’s recovery period slightly. Nevertheless, the child will improve and eventually return to normal bowel movements.

In conclusion, intestinal intussusception is a common condition in infants that requires swift intervention. Any delay in receiving treatment can lead to serious complications such as bowel perforation and necrosis of the telescoped intestine. If a child experiences vomiting, abdominal bloating, and constipation, it is essential to seek immediate medical attention to preserve the infant’s health and treat intestinal intussusception.

Frequently Asked Questions About Intestinal Intussusception

What is intestinal intussusception disease?

Intestinal intussusception is a medical condition in which one segment of the intestine telescopes into the segment that follows, causing compression of the telescoped portion and intestinal obstruction. It primarily affects male children between the ages of 6 months and 3 years.

Is intestinal intussusception a serious condition?

Yes, intestinal intussusception is a critical emergency that requires promptly restoring the telescoped segment to prevent interruption of its blood supply and subsequent tissue necrosis. Therefore, if a child experiences symptoms of intestinal obstruction and abdominal pain, it is crucial to seek immediate medical attention at the nearest hospital.

What are the symptoms of intestinal intussusception?

Infants with intestinal intussusception typically start crying intensely, lifting their legs, and rubbing them together due to severe abdominal pain. The crying may subside temporarily, only to return. Other possible symptoms include:

Vomiting and refusal to eat
Constipation
Abdominal bloating in later stages
Passage of small amounts of bloody stool

Can intestinal intussusception recur?

Yes, intussusception recurs in some patients, and its recurrence requires further investigations to find out the reason for the recurrence of intussusception and treat it so that it does not occur again.

Sources: