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Gastrointestinal medical emergencies
Intussusception
The loss of perfusion to an area of the intestine because the affected part of the intestin
of the intestine near the affected area
most commonly, occurs in infants aged 5-10 months.
most common cause of intestinal obstruction in patients aged 5 months to 3 years.
Signs and Symptoms:
Abdominal pain. In rare circumstances, the parents report 1 or more previous
pain within 10 days to 6 months prior to the current episode; pain in intussus
severe, and intermittent.
Knee to chest posturing,
Vomiting. Initially, vomiting is nonbilious and reflexive, but when the intestinal
vomiting becomes bilious.
Currant jelly stool. Parents also report the passage of stools that look like curra
mixture of mucus, sloughed mucosa, and shed blood or bloody stool
Lethargy. Lethargy is a relatively common presenting symptom with intussusce
lethargy occurs is unknown because lethargy has not been described with other
obstruction.
fever
constipation,
diarrhea.
Causes
Hyperperistalsis. The normal wave-like contractions of the intestine grab thi
and the lining of the intestine into the bowel ahead of it.
Digestive system activities. The unusual mobility of the cecum and ileum norm
life may also cause intussusception.
, 2
ultrasonography should be used as a first-line examination for the assessment o
intussusception.
CT scanning. Computed tomography (CT) scanning has also been proposed as
diagnose intussusception; however, CT scan findings are unreliable, and CT scan
associated with intravenous contrast administration, radiation exposure, and s
Contrast enema. The traditional and most reliable way to make the diagnosi
children is to obtain a contrast enema (either barium or air); contrast enema i
and has the potential to be therapeutic.
Note
Palpable sausage mass in the right upper quadrant
Interventions and Treatments:
Intravenous fluid. For all children, start intravenous fluid resuscitation and n
decompression as soon as possible.
Therapeutic enema. Therapeutic enemas can be hydrostatic, with either bari
contrast, or pneumatic, with air insufflation; therapeutic enemas can be perfor
fluoroscopic or ultrasonographic guidance; the technique chosen is not importan
radiologist performing the enema is comfortable with the method.
Surgical reduction. If a nonoperative reduction is unsuccessful or if obvious pe
promptly refer the infant for surgical care; risk of recurrence of the intussuscep
reduction is less than 5%.
Laparoscopy.
the surgical armamentarium in the treatment of intussusception;
performed in all cases of intussusception;
reduction of the intussusception,
confirmation of radiologic reduction
detection of lead points have all been reported.
weight-adjusted intravenous morphine as drug treatment
Nursing assessment
Gastrointestinal medical emergencies
Intussusception
The loss of perfusion to an area of the intestine because the affected part of the intestin
of the intestine near the affected area
most commonly, occurs in infants aged 5-10 months.
most common cause of intestinal obstruction in patients aged 5 months to 3 years.
Signs and Symptoms:
Abdominal pain. In rare circumstances, the parents report 1 or more previous
pain within 10 days to 6 months prior to the current episode; pain in intussus
severe, and intermittent.
Knee to chest posturing,
Vomiting. Initially, vomiting is nonbilious and reflexive, but when the intestinal
vomiting becomes bilious.
Currant jelly stool. Parents also report the passage of stools that look like curra
mixture of mucus, sloughed mucosa, and shed blood or bloody stool
Lethargy. Lethargy is a relatively common presenting symptom with intussusce
lethargy occurs is unknown because lethargy has not been described with other
obstruction.
fever
constipation,
diarrhea.
Causes
Hyperperistalsis. The normal wave-like contractions of the intestine grab thi
and the lining of the intestine into the bowel ahead of it.
Digestive system activities. The unusual mobility of the cecum and ileum norm
life may also cause intussusception.
, 2
ultrasonography should be used as a first-line examination for the assessment o
intussusception.
CT scanning. Computed tomography (CT) scanning has also been proposed as
diagnose intussusception; however, CT scan findings are unreliable, and CT scan
associated with intravenous contrast administration, radiation exposure, and s
Contrast enema. The traditional and most reliable way to make the diagnosi
children is to obtain a contrast enema (either barium or air); contrast enema i
and has the potential to be therapeutic.
Note
Palpable sausage mass in the right upper quadrant
Interventions and Treatments:
Intravenous fluid. For all children, start intravenous fluid resuscitation and n
decompression as soon as possible.
Therapeutic enema. Therapeutic enemas can be hydrostatic, with either bari
contrast, or pneumatic, with air insufflation; therapeutic enemas can be perfor
fluoroscopic or ultrasonographic guidance; the technique chosen is not importan
radiologist performing the enema is comfortable with the method.
Surgical reduction. If a nonoperative reduction is unsuccessful or if obvious pe
promptly refer the infant for surgical care; risk of recurrence of the intussuscep
reduction is less than 5%.
Laparoscopy.
the surgical armamentarium in the treatment of intussusception;
performed in all cases of intussusception;
reduction of the intussusception,
confirmation of radiologic reduction
detection of lead points have all been reported.
weight-adjusted intravenous morphine as drug treatment
Nursing assessment
