Pediatric Intussusception - An Overview
110 likes25,257 views
This document discusses intussusception, which is the telescoping of one segment of bowel into an adjacent segment. It provides definitions, etiology, types and pathology, signs and symptoms, differential diagnosis, workup, and treatment options for intussusception. The main points are that intussusception is usually idiopathic or caused by respiratory viruses in infants and young children, presenting with abdominal pain, vomiting, and bloody stools. Diagnosis involves imaging like ultrasound or barium enema. Treatment options include non-surgical reduction techniques like hydrostatic or pneumatic reduction or surgical reduction through manual manipulation or resection.
Pediatric Intussusception - An Overview
- 2. Dr.B.SELVARAJ MMSS;;MMcchh;;FFIICCSS;; • Neonatal & Pediatric Surgeon • Associate Professor • Melaka Manipal Medical college • Melaka- 75150 • Malaysia
- 3. OBJECTIVES • To discuss the etiology and pathophysiology of Intussusception • To discuss the differential diagnosis and to make you to clinch the correct diagnosis • To discuss various treatment options • Ultimately to make you confident in managing a case of Intussusception
- 4. PLAN • Definition • Etiology • Types and Pathology • History and Physical • Differential Diagnosis • Workup • Preoperative preparation • Management • Complications
- 5. INTUSSUSCEPTION Definition • Telescoping a segment of bowel into the adjacent segment • Usually proximal to distal • If distal to proximalRetrograde Intussusception
- 6. INTUSSUSCEPTION Etiology • Idiopathic • Respiratory viral infection Hypertrophy of Peyer’s patches • Meckel`s diverticulum, polyp,NHL, submucosal hematomacan act as Lead Point
- 7. INTUSSUSCEPTION Types and Pathology • Ileoileal • Ileocolocolic • Colocolic • Intussusceptum • Intussuscipiens • Strangulating obstruction
- 8. INTUSSUSCEPTION History Physical • Age: 2 months to 2 years • Male: Female 4:1 • Well built male baby with intermittent colicky pain • Blood and mucus in stool Red Currant Jelly stool • Bilious vomiting
- 9. INTUSSUSCEPTION History Physical • Mass in colonic region Sausage shaped • RIF empty Signe de Dance • PR may feel the mass • Mass coming out of Anus D/d Prolapse Rectum
- 10. INTUSSUSCEPTION Differential Diagnosis • Anal Fissure • Juvenile Polyp • Multiple Polyposis • Colitis • Intestinal Duplication • Malrotation with Volvulus • Meckel`s Diverticulitis • Dysentery • Hemorrhoids
- 11. INTUSSUSCEPTION workup • AXR-- Erect Small bowel obstruction • Barium Enema Spincer shaped ending / Spring coil appearance/ Meniscus sign • USG Abdomen Target Sign and Pseudo Kidney appearance
- 14. INTUSSUSCEPTION Preoperative Preparation • NPO • NGT aspiration • I.V. Antibiotics • If in Shock Resuscitate • CBD and I/O Chart • Type and crossmatch group specific wholeblood
- 15. INTUSSUSCEPTION Management • Barium enema reduction • Hydrostatic saline reduction • Pneumo reduction • Laparotomy and Manual Reduction “Milking manuver” • Laparotomy and Resection of gut with anastomosis
- 24. INTUSSUSCEPTION Complications • Wound infection • Short bowel syndrome • Fecal fistula