Bowel obstruction in children

Bowel obstruction in children may be congenital and acquired.
Congenital intestinal obstruction associated with congenital defects intestine (atresia, stenosis and other). The clinical picture depends on the level of obstruction. At high intestinal obstruction immediately or soon after birth appears persistent vomiting mixed with bile vomit mass. The chair is absent or delayed. In epigastralna (epigastric) observed bloating, disappearing after vomiting. At low congenital intestinal obstruction leading symptom - stool retention. Vomiting is attached later on 2-3-day life, belly swollen, peristalsis strengthened. If belated diagnosis may come perforation (perforation) of the intestine with the subsequent development of peritonitis.
Among the various forms purchased intussusception in children on the first place on the frequency should check it out here. It develops almost exclusively in infants, usually between the ages of 4 months. up to 1 year. The disease begins suddenly with anxiety attacks and motor excitation (because of the pain), alternating bright intervals. Soon vomiting. The temperature remains normal, can be one-, two-chair with blood or blood and mucus. When viewed in time of peace the abdomen is soft, with finger study through the rectum on the finger, as a rule, is determined by the blood.
Acquired bowel obstruction in children may be associated with fecal stagnation (coprostasis) at a sluggish bowel function, some malformations (see Megacolon, cystic Fibrosis) or obstruction of the gut worms with ascariasis. In these cases, bowel obstruction often proceeds by type partial.
Adhesive intestinal obstruction in children is less common with the flow a little than differs from adhesive intestinal obstruction in adults.
Dynamic bowel obstruction in children is most often caused by intestinal paresis and occurs when pneumonia, inflammatory processes in other organs (especially in infants), as well as peritonitis and toxic conditions of various origin. Clinical manifestations less pronounced than in the mechanical intestinal obstruction. Marked stool retention, bloating, sharp weakening or absence of peristalsis, often vomiting. The children are restless. Decisive in the diagnosis is x-ray examination.
Forecast in intussusception in children depends on the timing of early treatment and intervention. Especially serious prognosis in advanced cases. In this regard, early hospitalization is crucial.
Treatment. All children with suspected intestinal obstruction subject of urgent hospitalization. Conservative treatment is valid only when the dynamic obstruction of the intestine: enema with hypertonic solution, stomach wash, neostigmine subcutaneously, hypertonic solutions intravenously. When coprostasia and intestinal obstruction caused by worms, treatment begins with cleansing and siphon enemas with a 1% solution of sodium chloride. The ineffectiveness of these activities - operation.
When intussusception in terms of up to 24 hours from the moment of the disease, conservative smoothing of invaginate by introducing air into the rectum (under radiological control).
At a later date, and the ineffectiveness of the conservative unfolding shown urgent surgery.
For all other types of intestinal obstruction (congenital, adhesive and so on) shows emergency surgery (cutting of adhesions, smoothing inversion, resection of part of intestine and other).