Intestinal obstruction in children symptoms

Ileus or obstruction of the small intestine or colon in children and adults, i.e. blockage of the small or large intestine, is one of the causes of disorders of the gastrointestinal tract that needs to be resolved through immediate surgery. It is therefore necessary to seek medical help immediately, as soon as the child or adult first symptoms appear.

Acquired intestinal obstruction in children and adults is a condition that directly threatens life.

Reasons

The reasons why there is an acute intestinal obstruction in children and adults, determine the types of ileus:

• mechanical (formed by preventing the passage of intestinal contents, for example, due to tumor, foreign bodies or biliary stone),
• neurogenic (formed due to weakened peristalsis of the intestines),
• vascular (may occur e.g. in situation when the clot clogged the vessels of the intestine, the gut due to the lack of blood is not moving).

Trappings

Important role in the early detection of intestinal obstruction play a different symptoms. For all types of obstruction, however, has similar manifestations:

• constipation and bloating, with no tendency towards relief,
• the increase in the volume of the stomach ("swollen belly" flatulence bowel),
• abdominal pain and vomiting,
• sometimes persistent compulsive nausea,
• palpitations and heavy breathing,
• the visible pale face, cold sweat on forehead and body,
• drowsiness.

Types

Mechanical ileus

• obstructive – blockage of the lumen of the intestine, for example, tumor, food,
• inversion – rotation of the intestine around its own axis,
• strangulation – intestines blocked from the outside, for example, adhesions after previous surgery, strangulated hernia,
• intussusception – insert part of the intestine into the lumen of the adjacent segment.

Neurogenic ileus – functional

• paralytic – expansion of intestinal loops with blocking of intestinal motility after surgery on the abdominal cavity, peritonitis, after abdominal injuries, the affected part of the bowel is losing momentum and tone,
• spastic – a narrowing of the intestine caused by the contraction of the intestinal muscles in diseases of the nervous system.

Vascular obstruction

• blockage of the mesenteric artery embolus or thrombus with subsequent ischemia of the bowel and rapid development of peritonitis.

Etiology

For each type of ileus significantly different.

Mechanical ileus – obstruction, hinder the digestive tract contents through the lumen:

• Inversion is invoked by the rotation of the stomach or intestines around the axis. If the rotation exceeds 180 degrees, in the bowel wall does not occur any pathologic changes. At high revs it also covers blood vessels and nerves in the mesentery.

• The strangulation, the bowel is clamped external adhesions or hernias.

• Invagination of the insert portion of the intestine into the adjacent segment. The cause may be congenital (affecting children under one year) or in adulthood when polyps in the intestine.

• Obstructive – the reason is to block the lumen of the intestine without damaging the nutrition of the intestinal wall. Clinical symptomdeveloped in accordance with the number of obstacles. The greater the obstacle, the more pronounced clinical symptoms. According to the cause of the obstruction is further divided into: internal intestinal – occurs when the invasion barrier in the gastrointestinal tract (gallstones, solid food, parasites), intramural wall of the intestine is affected most frequently, the tumor grows gradually and blocks the intestinal lumen, extramurally – is the result of mechanical compression of the intestine from the outside, in particular, spikes (after previous surgery), which hamper the movement of the intestine and the lumen, or growing tumors, especially gynecological in the late stages.

Neurogenic ileus and functional, divided into:

• Paralytic – expansion of intestinal loops with a stop of peristalsis after surgery on the abdominal cavity, peritonitis, trauma, abdominal reflex spinal injuries and spinal cord, can occur in biliary and renal colic.

• Spastic – this can be caused by some diseases of the nervous system (meningitis, spinal cord injury).

Vascular obstruction

Occurs as a result of embolism or thrombosis of mesenteric arteries often in cardiovascular diseases, atherosclerosis.

Clinical picture

Mechanical ileus

• sudden abdominal pain with intervals of no pain, the more advanced the process, the more intervals without pain can become more continuous nature,
• vomiting, later – and the contents of the intestine, these symptoms are typical for obstacles in the upper gastrointestinal tract,
• stop gas and feces – signs, characteristic for low-lying obstacles,
• distended abdomen with signs of intense peristalsis,
• symptoms of metabolic decay in an advanced stage,
• large bowel obstruction develops slowly, the symptoms are less pronounced.

Neurogenic ileus

Paralytic ileus: a feeling of bloating, pain in the stomach, stop gas and defecation, vomiting occurs later.

Spastic bowel obstruction: colicky pain, increased peristalsis, vomiting.

Vascular ileus

• sudden severe abdominal pain lasting for about 2 hours, followed by an asymptomatic period with subsequent development of peritonitis,
• vomiting which may contain blood,
• signs of shock, peritoneal irritation (fever, abdominal pain, vomiting, tachycardia, hypotension, shallow breathing),
• quick stop intestinal passage.

Diagnostics

Therapy

Treatment always should begin with the introduction of a nasogastric tube, aspiration of gastric contents and replenishment of lost fluid and minerals parenteral.

Mechanical obstruction is always surgical treatment

Obstructive obstruction

• ileus intraluminal therapy is to serve enterotomy (the eruption of the wall of the intestine) and elimination barriers,
• intramural – the cause is often a tumor mainly compressive intestine outside, and the elimination of obstacles is undertaken later in the period and improve the overall human condition,
• extramurally - in most cases, the ileus is inoperable, the establishment of the terminal stoma.

Volvulus

Recommended immediate surgical treatment consisted of derotation facing of the colon and its fixation in the correct position. In case of violation of functionality, it is necessary to perform a resection of the affected segment.

Strangulation

If there are adhesions, performed surgical incision of the band, about the next steps, the decision is taken based on the state of the intestinal wall. In case of violation of functionality required resection of the affected segment.

Intussusception

Surgical treatment involves pushing invigilance by removing its causes in order to prevent a relapse. In case of violation of functionality required resection of the affected segment.

Neurogenic obstruction

Treatment is conservative:

• a nasogastric tube,
• parenteral replenishment of fluid and minerals,
• exception oral,
• the treatment of tone and motility (prokinetics) – with paralytic ileus,
• medications that ease spasms (antispasmodic drugs) – spastic ileus,
• removal reasons.

Vascular obstruction

Timely surgery: embolectomy, thrombectomy, in violation of the functionality of the resection of the affected area and anastomosis "end to end".

Complications: intestinal perforation, peritonitis,shock.

id="i-22">bowel Obstruction in children

Intussusception is a life-threatening condition in early childhood. The typical symptoms are severe abdominal pain, which come in bouts that don't last long and alternate hourly periods of rest. In the rectum during urge to defecate is detected the blood. You need a rapid surgical intervention.

Intussusception is most common among children, the highest percentage of cases occur in children of preschool age.

Intestinal obstruction in children is known as a partial or complete blockage of the small or large intestine. This condition prevents the passage of food and feces, and may endanger the child's life. Such conditions include: pyloric stenosis, intestinal atresia, intestinal stenosis, intestinal adhesions, bowel cancer, volvulus.

Ileus in a child with the following signs: convulsions, abdominal pain, nausea and vomiting, diarrhea, loss of appetite, fever.

Symptoms vary depending on the blockage: partial or complete blockage.

The lesions of the small bowel is reflected cramps and abdominal pain. The pain may be acute and widespread, permanent or periodic. May be accompanied by nausea and vomiting. Vomited material often contains bile (green fluid secreted by the liver). It also may contain blood or feces.

The child may receive heat and fever.

Pain and increase in abdomen indicate blockage of the colon. The child cannot go to the toilet or he did not depart gases. Diarrhea can be a symptom of partial obstruction. The child may become Moody, restless, loses appetite, often leads to dehydration and loss of body weight. You should immediately begin treatment. If the lock is removed, the child will not be able to eat normally, therefore, will have to stay in hospital and receive intravenous feeding.

Did you know that…

... There were cases when ileus resulted swallowing chewing gum!