Clinical Reference Systems: Pediatric Advisor 10.0
Intussusception
Admission and Discharge Instructions
Description
Intussusception occurs when one portion of the intestine
folds in on itself, much like a collapsing telescope, and
puts pressure on another part of the intestine.
The main symptom is sudden, severe abdominal pain. The pain
comes and goes and lasts seconds to minutes. The waves of
pain occur every 5 to 15 minutes. During attacks of pain
the child will cry or scream. Between attacks of pain the
child may appear to be well.
Other possible symptoms, in addition to pain, are:
- vomiting
- bloody stools
- pale skin.
Intussusception is most common between 6 months and 2 years
of age, but it can occur at any age.
Cause
The exact cause of intussusception is not known. It
sometimes happens when a child has a cold or other viral
illness associated with swollen glands. There are glands
located in the wall of the intestine and swelling of these
glands can cause the bowel to telescope.
When the bowel telescopes, there is less blood flow to the
intestine. The decreased blood flow causes pain and bloody
stools. The intestine can also become blocked, which can
cause the child to vomit.
Reasons for Admission to the Hospital
Main complication: ________________________________________.
__ Needs IV fluids.
__ Needs IV antibiotic or other medication.
__ Recovery from surgery.
__ Other reasons. _________________________________________.
Hospital Treatment
- Rehydration
If your child's bowel is blocked, it may be difficult for
your child to absorb fluids. Your child will be given
some fluids intravenously (through a vein). Your child
probably will have a tube placed through the nose down
into the stomach to help control vomiting.
- Barium or air enema
The most important part of the treatment is getting your
child's intestines back to their usual position. This
can often be done by giving the child a special x-ray
test called a barium or air enema.
During an enema a tube is put into the child's rectum. A
barium solution (and/or air, if it is an air enema) is
passed through the tube into the intestine while a
technician takes several x-rays. This test does two
things. It helps the doctor see what is wrong by showing
an x-ray picture of exactly where the problem is in your
child's intestine. It also treats the illness because
the solution and/or air from the enema gently pushes the
telescoped part of the child's bowel back to where it
belongs.
The enema should take about only 10 minutes. During the
test your child may feel some cramping pain.
If the enema is successful, your child will not need
further treatment. He or she will be observed for a
short period of time in the hospital to make sure that
the condition does not recur.
- Surgery
If the barium or air enema is not successful in fixing
the problem, or if your child is extremely unwell because
of the intussusception, your child will need surgery.
During the operation the surgeon will unfold the
telescoped bowel and return it to its normal position.
Requirements for Discharge
- _______________________________________________________
- _______________________________________________________
- _______________________________________________________
Discharge Instructions for Home Care
- No restrictions
Once your child has been treated and discharged, there
are no specific things that you have to do at home. Your
child may eat and drink normally and should be encouraged
to return to his or her usual level of activity.
Although intussusception recurs in only 5% to 10% of all
cases, it is important to watch for the return of any of
the symptoms.
- Other medicines
For pain or fever over 102ƒF (39ƒC) give
__________________________
___________________________________________________________
___________________________________________________________
- Additional instructions
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Follow-up Appointment after Discharge
___ Your child needs to be rechecked and has an appointment
on _____________ at _______ with
_________________________.
___ Your child needs to be rechecked in ________ days. Call
your child's doctor to make an appointment.
___ A follow-up appointment is not necessary. Call your
doctor if you have any concerns.
Call Your Child's Doctor IMMEDIATELY If:
- Symptoms of intussusception return.
- Your child starts to act very sick.
Call Your Child's Doctor During Office Hours If:
- You have other questions or concerns.
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