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INTUSSUSCEPTION

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Invagination of one portion of the intestine intoanother

Condition in which one part of the intestine becomespushed into the lumen of an adjoining segment

One of the frequent causes of intestinal obstruction inchildren between the ages of 3 months and 3 years

INTUSSUSCEPTION

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etiologyChildren:

y the cause is unknown

y Possible triggers may be:

-V iral infection (Rota V irus)-A noncancerous growth or a cancerous tumor in the

intestine

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PROGNO SISy N on operative successful in more than 75% of cases

y Untreated: spontaneous reduction or chronicintussusception

-90 % : suffer for complications such as perforation,peritonitis & sepsis.

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DIAGNO STIC TEST:

y BARIUM ENEMA -clearly demonstrates the obstruction to the

flow of barium-definitive test

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Medical Managementy Initial treatment of choice:

N ON SURGIC AL HYDROST A TIC REDUCTION

BA RIUM EN EMA- diagnostic and therapeuticContraindicated: Perforation

Water -soluble Contrast and A ir Pressure/Enema

y Carbon Dioxide Pressure

y I V fluids, N GT decompression, A ntibiotic therapy may be usedbefore attempts at hydrostatic reduction are made.

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Sur gical Managementy if enema was unsuccessful-pts who show signs of shock or peritonitis

-symptoms presented longer than 24 hrs

y manually reducing the invagination

y LA P A ROTOM Y for multiple recurrences

-resection of any nonviable intestine

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N urs ing Management

y LISTEN to the parents description of the child s physicaland behavioral symptoms

y Explain to the parents the need for immediatehospitalization. Offer emotional support: parents areunprepared

y Observe/ monitor stools - normal BROW N stool indicatesthat the intussusception has reduced itself

y Monitor vital signs. Infants may become hypothermic atthe onset of infection; Temp: sepsis, PR and dec BP:peritonitis

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P ost-procedural care:y Monitor vital signs

y Check for the return of the bowel sounds

y Monitor pt who has undergone hydrostatic reduction

for passage of stools and barium or water -solublecontrast material

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P re-operative care

y Maintain N PO status as ordered

y Routine laboratory testing (C BC and U A )

y P A REN T AL CON SEN T

y Pre-anesthetic sedation

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