Infant Disorders: Intussusception Flashcards
What is intussusception?
Part of intestine invaginate into adjacent parts
Where is it most likely to happen?
narrow bowel moves to wider bowel
What is a common area of invagination?
ileocecal valve = where end of small intestine, the ileum pushes into the beginning of lrg intestine, the cecum d/t an increase pressure in ileum
Prevalence?
~1-4 in 1000 births
Can it occur in adults? how?
Yes
d/t tumor –> cause inflm –>increase pressure on the wall–> cause a telescoped bowel
What is a telescoped bowel?
When the small bowel collapse to the large bowel like a telescope–> blocks fluid or food passing thru
Pathophysiology of Intussusception
obstr. at site of invagination–> inflm–> ischemia
Explain how invagination leads to edema
invagination–> bowel obstr.—> inflm–> increase prod of exudate, hyperemia–> edema
Explain how bowel obstr. lead to infarction
bowel obstruction leads to increase intraluminal pressure –> pushes against the wall –> constricts vessels in bowel wall –> ischemia–> infarction
What are the complications? How?
infarction, perforation, and peritonitis
necrotic tissue from obstruction results in perforation –> bacteria within intestines can infect necrotic tissues –> bacterial peritonitis
Why is it serious in infants?
infant have small fluid volume and defenses are not in place therefore substantial fluid shift w/ 3rd spacing and infection can be fatal.
Treatment of Intussusception
- hydrostatic reduction
2. sx???
How does hydrostatic reduction treat Intussusception?
the use of endoscope to introduce water soluble contrast medium (fluid) and air to push back the invaginated area
When does it require sx?
When there is an obstruction b/c it leads to perforation.
