Intestinal obstruction (pediatric) - series

Answer 1

Normal anatomy

The small intestine is basically a long tube through which digested food passes.

Indications, part 1

Intussusception is a common cause of bowel obstruction in children. It occurs when a segment of small bowel "telescopes" on itself, thus causing swelling, obstruction, and eventually intestinal gangrene.

Indications, part 2

Intussusception is suspected if the child has experienced sudden, severe abdominal pain, blood and mucous in the stool, and vomiting. Abdominal X-rays are usually taken to confirm the diagnosis. A barium enema may be used for diagnosis. Barium, a heavy, radio-opaque dye, is administered through the rectum, fills the bowel, and allows for visualization of the bowel by x-rays. This procedure is sometimes successful in correcting the problem- the weight of the barium itself in the bowel frequently reduces the telescoped bowel. If intussusception is diagnosed and not corrected by barium enema, surgery is necessary IMMEDIATELY to prevent complications such as obstruction, gangrenous bowel and peritonitis.

Incision

While the child is deep asleep and pain-free (using general anesthesia), an incision is made in the abdomen, usually in the midline. The bowel obstruction site is located, the obstruction is relieved, and the bowel is examined for injury. Injured sections are removed and the healthy ends of the bowel are either stitched together or brought out onto the abdomen temporarily (colostomy).

Aftercare

Generally, patients are able to go home within 5-10 days after surgery, depending on how long it takes the intestines to recover from the surgical procedure.

Reviewed By

Review Date: 05/17/2010

Shabir Bhimji, MD, PhD, Specializing in Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.