- Intussusception definition
Содержание
- 2. INTUSSUSCEPTION DEFINITION Telescoping of a proximal segment of the intestine (intussusceptum) into a distal segment (intussuscipiens)
- 4. INTUSSUSCEPTION ANATOMIC LOCATIONS ILEOCOLIC MOST COMMON IN CHILDREN ILEO-ILEOCOLIC SECOND MOST COMMON ENTEROENTERIC ILEO-ILEAL, JEJUNO-JEJUNAL MORE
- 6. PATHOPHYSIOLOGY Precipitating mechanism unknown Obstruction of intussusceptum mesentery Venous and lymphatic obstruction Ischemic necrosis occurs in
- 7. PATHOPHYSIOLOGY Majority occur in the region of the ileocecal valve (80%) DISPROPORTIONATE DIAMETERS OF ILEUM AND
- 9. ETIOLOGIES Majority of pediatric intussusceptions idiopathic (85-90%) LYMPHOID HYPERPLASIA POSSIBLE ETIOLOGY Mechanical abnormalities may act as
- 10. EPIDEMIOLOGY Incidence 2 - 4 / 1000 live births Usual age group 3 months - 3
- 11. INTUSSUSCEPTION CLINICAL CHARACTERISTICS Early Symptoms PAROXYSMAL ABDOMINAL PAIN SEPARATED BY PERIODS OF APATHY POOR FEEDING AND
- 12. CLINICAL SYMPTOMS BY AGE INTERMITTENT PAIN (85%) VOMITING (78%) BLOOD IN STOOL (36%) INTERMITTENT PAIN (95%)
- 13. CLINICAL SYMPTOMS BY DURATION INTERMITTENT PAIN (85%) VOMITING (78%) BLOOD IN STOOL (36%) INTERMITTENT PAIN (95%)
- 14. PHYSICAL EVALUATION Moderately to severely ill Irritable, limited movement Most are at least 5-10% dehydrated 80%
- 15. INTUSSUSCEPTION STAGES I. Bright clinical manifestation II. Pseudodysenteric stage III. Peritonitis
- 16. Ultrasonic diagnostics
- 20. RADIOGRAPHIC EVALUATION Plain radiographs (acute abdominal series) Plain films suggestive in majority, but cannot rule out
- 25. TREATMENT Obstructive surgical emergency Pediatric surgeon notified immediately Supportive Therapy AGGRESSIVE FLUID RESUSCITATION ELECTROLYTES NASOGASTRIC TUBE
- 26. Radiographic HYDROSTATIC (BARIUM, WATER SOLUBLE CONTRAST) Operative MANUAL RESECTION AND REANASTAMOSIS
- 27. INTUSSUSCEPTION PNEUMATIC REDUCTION Theoretical Advantages LESS INFLAMMATION IF PERFORATION OCCURS Method AIR INSUFFLATION LIMITED TO MAXIMUM
- 28. INTUSSUSCEPTION NON-OPERATIVE REDUCTION CONTRAINDICATIONS Absolute Contraindications PERITONEAL SIGNS SUSPECTED PERFORATION Relative Contraindications SYMPTOMS > 24-48 HRS
- 29. INTUSSUSCEPTION FAILURE OF NON-OPERATIVE REDUCTION Factors associated with failure SYMPTOMS > 48 HRS RECTAL BLEEDING SMALL
- 30. INTUSSUSCEPTION POST-REDUCTION TREATMENT Admit patient for 24 hours May attempt feeding within 12 hrs Return to
- 31. Surgical treatment
- 33. Acquired intestinal obstruction Acquired intestinal obstructions are a partial or complete blockage of the small or
- 34. Intestinal obstructions can be mechanical or nonmechanical. Mechanical obstruction is caused by the bowel twisting on
- 36. Non-mechanical obstruction occurs when the normal wavelike muscular contractions of the intestinal walls (peristalsis), which ordinarily
- 37. Clinic 1. Abdominal pain 2. Vomiting 3. Constipation 4. Intoxication syndrome
- 38. Diagnosis X-ray examination Ultrasonic diagnostics Computed tomography Diagnostic testing will include a complete blood count (CBC),
- 41. Treatment Preoperative preparation: a. inserting a nasogastric tube to suction out the contents of the stomach
- 42. Surgical treatment
- 47. Скачать презентацию
INTUSSUSCEPTION
DEFINITION
Telescoping of a proximal segment of the intestine (intussusceptum) into
INTUSSUSCEPTION
DEFINITION
Telescoping of a proximal segment of the intestine (intussusceptum) into
INTUSSUSCEPTION
ANATOMIC LOCATIONS
ILEOCOLIC
MOST COMMON IN CHILDREN
ILEO-ILEOCOLIC
SECOND MOST COMMON
ENTEROENTERIC
ILEO-ILEAL, JEJUNO-JEJUNAL
MORE COMMON IN
INTUSSUSCEPTION
ANATOMIC LOCATIONS
ILEOCOLIC
MOST COMMON IN CHILDREN
ILEO-ILEOCOLIC
SECOND MOST COMMON
ENTEROENTERIC
ILEO-ILEAL, JEJUNO-JEJUNAL
MORE COMMON IN
PATHOPHYSIOLOGY
Precipitating mechanism unknown
Obstruction of intussusceptum mesentery
Venous and lymphatic obstruction
Ischemic necrosis occurs
PATHOPHYSIOLOGY
Precipitating mechanism unknown
Obstruction of intussusceptum mesentery
Venous and lymphatic obstruction
Ischemic necrosis occurs
PATHOPHYSIOLOGY
Majority occur in the region of the ileocecal valve (80%)
DISPROPORTIONATE
PATHOPHYSIOLOGY
Majority occur in the region of the ileocecal valve (80%)
DISPROPORTIONATE
ETIOLOGIES
Majority of pediatric intussusceptions idiopathic (85-90%)
LYMPHOID HYPERPLASIA POSSIBLE ETIOLOGY
Mechanical abnormalities
ETIOLOGIES
Majority of pediatric intussusceptions idiopathic (85-90%)
LYMPHOID HYPERPLASIA POSSIBLE ETIOLOGY
Mechanical abnormalities
EPIDEMIOLOGY
Incidence 2 - 4 / 1000 live births
Usual age group
EPIDEMIOLOGY
Incidence 2 - 4 / 1000 live births
Usual age group
INTUSSUSCEPTION
CLINICAL CHARACTERISTICS
Early Symptoms
PAROXYSMAL ABDOMINAL PAIN
SEPARATED BY PERIODS OF APATHY
POOR FEEDING AND
INTUSSUSCEPTION
CLINICAL CHARACTERISTICS
Early Symptoms
PAROXYSMAL ABDOMINAL PAIN
SEPARATED BY PERIODS OF APATHY
POOR FEEDING AND
CLINICAL SYMPTOMS BY AGE
INTERMITTENT
PAIN (85%)
VOMITING (78%)
BLOOD IN STOOL (36%)
INTERMITTENT
PAIN (95%)
VOMITING
CLINICAL SYMPTOMS BY AGE
INTERMITTENT
PAIN (85%)
VOMITING (78%)
BLOOD IN STOOL (36%)
INTERMITTENT
PAIN (95%)
VOMITING
CLINICAL SYMPTOMS BY DURATION
INTERMITTENT
PAIN (85%)
VOMITING (78%)
BLOOD IN STOOL (36%)
INTERMITTENT
PAIN (95%)
VOMITING
CLINICAL SYMPTOMS BY DURATION
INTERMITTENT
PAIN (85%)
VOMITING (78%)
BLOOD IN STOOL (36%)
INTERMITTENT
PAIN (95%)
VOMITING
PHYSICAL EVALUATION
Moderately to severely ill
Irritable, limited movement
Most are at least
PHYSICAL EVALUATION
Moderately to severely ill
Irritable, limited movement
Most are at least
INTUSSUSCEPTION
STAGES
I. Bright clinical manifestation
II. Pseudodysenteric stage
III. Peritonitis
INTUSSUSCEPTION
STAGES
I. Bright clinical manifestation
II. Pseudodysenteric stage
III. Peritonitis
Ultrasonic diagnostics
Ultrasonic diagnostics
RADIOGRAPHIC EVALUATION
Plain radiographs (acute abdominal series)
Plain films suggestive in majority,
RADIOGRAPHIC EVALUATION
Plain radiographs (acute abdominal series)
Plain films suggestive in majority,
TREATMENT
Obstructive surgical emergency
Pediatric surgeon notified immediately
Supportive Therapy
AGGRESSIVE FLUID RESUSCITATION
ELECTROLYTES
NASOGASTRIC TUBE PLACEMENT
TREATMENT
Obstructive surgical emergency
Pediatric surgeon notified immediately
Supportive Therapy
AGGRESSIVE FLUID RESUSCITATION
ELECTROLYTES
NASOGASTRIC TUBE PLACEMENT
Radiographic
HYDROSTATIC (BARIUM, WATER SOLUBLE CONTRAST)
Operative
MANUAL
RESECTION AND REANASTAMOSIS
Radiographic
HYDROSTATIC (BARIUM, WATER SOLUBLE CONTRAST)
Operative
MANUAL
RESECTION AND REANASTAMOSIS
INTUSSUSCEPTION
PNEUMATIC REDUCTION
Theoretical Advantages
LESS INFLAMMATION IF PERFORATION OCCURS
Method
AIR INSUFFLATION LIMITED TO MAXIMUM
INTUSSUSCEPTION
PNEUMATIC REDUCTION
Theoretical Advantages
LESS INFLAMMATION IF PERFORATION OCCURS
Method
AIR INSUFFLATION LIMITED TO MAXIMUM
INTUSSUSCEPTION
NON-OPERATIVE REDUCTION CONTRAINDICATIONS
Absolute Contraindications
PERITONEAL SIGNS
SUSPECTED PERFORATION
Relative Contraindications
SYMPTOMS > 24-48 HRS
RECTAL
INTUSSUSCEPTION
NON-OPERATIVE REDUCTION CONTRAINDICATIONS
Absolute Contraindications
PERITONEAL SIGNS
SUSPECTED PERFORATION
Relative Contraindications
SYMPTOMS > 24-48 HRS
RECTAL
INTUSSUSCEPTION FAILURE OF NON-OPERATIVE REDUCTION
Factors associated with failure
SYMPTOMS > 48 HRS
RECTAL
INTUSSUSCEPTION FAILURE OF NON-OPERATIVE REDUCTION
Factors associated with failure
SYMPTOMS > 48 HRS
RECTAL
INTUSSUSCEPTION
POST-REDUCTION TREATMENT
Admit patient for 24 hours
May attempt feeding within 12
INTUSSUSCEPTION
POST-REDUCTION TREATMENT
Admit patient for 24 hours
May attempt feeding within 12
Surgical treatment
Surgical treatment
Acquired intestinal obstruction
Acquired intestinal obstructions are a partial or complete
Acquired intestinal obstruction
Acquired intestinal obstructions are a partial or complete
Intestinal obstructions can be mechanical or nonmechanical.
Mechanical obstruction is caused
Intestinal obstructions can be mechanical or nonmechanical.
Mechanical obstruction is caused
Non-mechanical obstruction occurs when the normal wavelike muscular contractions of the
Non-mechanical obstruction occurs when the normal wavelike muscular contractions of the
Clinic
1. Abdominal pain
2. Vomiting
3. Constipation
4. Intoxication syndrome
Clinic
1. Abdominal pain
2. Vomiting
3. Constipation
4. Intoxication syndrome
Diagnosis
X-ray examination
Ultrasonic diagnostics
Computed tomography
Diagnostic testing will include a complete blood
Diagnosis
X-ray examination
Ultrasonic diagnostics
Computed tomography
Diagnostic testing will include a complete blood
Treatment
Preoperative preparation:
a. inserting a nasogastric tube to suction out the
Treatment
Preoperative preparation:
a. inserting a nasogastric tube to suction out the
Surgical treatment
Surgical treatment
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Врожденная гипоплазия легких
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Первые признаки инсульта
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