Definition and causes
Invagination is a special kind of tarmslyng , Where part of the intestine forskubbes into another part. Usually this is done on the transition between the last paragraph of the small intestine and the first piece of the large intestine, so that the small intestine pushed tyktarmens home. The result is a afklemning of the small intestine, thus blocking the passage of the gut and possible. prevents the blood supply to the affected part of the intestine.
The causes of intussusception is often unknown. It is believed that the enlarged lymph nodes around the intestine provides an increased risk. Thus, intussusception more frequently by betændelsesreaktion in and around the gut, for example. by allergic purpura . A vaccine against Rotavirus, which is the leading cause of virusudløst stomach-intestinal catarrh (viral gastroenteritis ), Was not marketed because it gave an increased risk of intussusception. It is believed that tarmpolypper and Meckels divertikel , Which will be caught by tarmens movements can cause intussusception.
Invagination is the highest in 6 to 18 months of age.
Symptoms of intussusception
The symptoms develop gradually and begin with turevise severe abdominal pain (koliksmerter). Between smerteanfaldene there are no symptoms. Smerteanfaldene will often show itself as skrigeture, but parents or doctor may have the impression that the pain comes from the stomach.
Subsequent developed the classic symptoms, which are:If invaginationen not treated or corrected out of itself, may arise shock , Which is a life-threatening condition.
Precautions and diagnosis
Children under 1-1 ½ years of strong turevise abdominal pain should be seen by a doctor as soon as possible. A doctor should always suspect intussusception in children under 2 years of turevise abdominal pain. By suspicion of intussusception should the child hospitalised acute in a hospital with børneafdeling and gastro-intestinal surgical expertise.
The diagnosis made on sygehistorien and examination of the child. Fund by filling in the lower right side of the abdomen and bloody diarrhoea support the diagnosis. It will take an X-ray of the intestines, which will show signs of tarmslyng . Then performed a indhældning of contrast in the intestine through endetarmen and take even an X-ray, which makes the diagnosis.
Consideration of intussusception
Often, indhældning of contrast media through endetarmen to røntgenundersøgelsen to formulate the gut out, and thus act as treatment. If so, it must be remembered that intussusception can come back and be aware of the symptoms return.
If indhældning by contrast is insufficient, or the child is very ill, treatment will be acute surgery. During the operation the surgeon will attempt to correct the gut. If the intestine has been without blood for too long, is the affected part of land, and it may be necessary to remove the damaged piece.
Select and complications
Invagination is a potentially life-threatening condition, but the prognosis is often good, especially if treatment is started in time.
The complexity of intussusception is shock and sepsis (blood poisoning), both of which are life-threatening conditions.
As mentioned in behandlingsafsnittet it can in severe cases be necessary to remove a piece of intestine. In this context, it may be necessary to bring a temporary stoma (presentation of a gut-end through the tummy). This will often be paid back after a few months.