Intestinal obstruction in newborns symptoms

Intestinal obstruction in a newborn has several causes, associated symptoms and manifestations.

Division and the reasons

Intestinal obstruction in newborns is divided as follows:

1. Duodenal – stenosis, atresia, congenital membrane, a cyst of the common bile duct, portal vein prabodhananda.
2. Intestinal – malattia and volvulus, atresia.
3. Iliac Makarieva obstruction, atresia, inguinal hernia, paralytic ileus.
4. Obstruction of the colon – Hirschsprung's disease, Makarieva tube, a perforated anus, atresia.

Duodenal obstruction

Ileus this type is the most common.

1. Stenosis /atresia is the symptom of "double bubble", also evident in the fetus from hydramnion obstruction associated with annular pancreas (20%), Mongolism (30%) and other anomalies of the gastrointestinal tract.
2. Annular pancreas – if this problem is not associated with duodenal atresia, it can be diagnosed at an older age.
3. A congenital syndrome of Ledda – the inversion of the gut, attached to liver, abdominal wall and cecum, as a rule, passes through the duodenum: effects on the anterior wall of the duodenum.
4. Congenital membrane.
5. Cyst of the common bile duct.
6. Prabodhananda portal vein.
7. Inversus, duodenal ulcer – an abnormal fixation of the descending duodenum: duodenal slow passage and reduced emptying of the stomach, leading to gastritis.

Obstruction of the small intestine:

1. Malattia and inversion.
2. Atresia in half of the cases also atresia distal.

Transient obstruction

1. Atresia.
   Inguinal hernia.
   Paralytic congenital intestinal obstruction in newborns, occurs as a result of drugs administered to the woman during childbirth.
2. Makarieva obstruction is called meconium affects the distal part of the ileum, utero occurs in 15%: almost always associated with cystic fibrosis – cystic fibrosis is found in 10-15% of children with cystic fibrosis, lung disease, lesions of the duodenum, the treatment machiavelo ileus possible with the help of irrigography with Gastrografin (pay attention to the balance of fluids and electrolytes!) or enemas with NAC, in the absence of treatment in children with cystic fibrosis often at the age from 6 months to 3 years there is prolapse of the rectum (with no direct link to meconial obstruction).

Obstruction of columns

Hirschsprung's disease – ganglion in 4% of cases – hereditary:

• boys suffer from obstruction of this type in 4-9 times more often than girls,
• the lack of muscle (Meissner) and submucosal (Auerbach's) plexus of parasympathetic ganglia – comes to the migration of neuroblasts,
• Econoline does not depart more than 24 hours, periodic constipation and paradoxical diarrhea, before irrigography not to hold an enema, and digital forensics,
• symptoms often occur already in the first week,
• put the baby on his stomach for a time from 20 to 30 minutes, then make the side – sometimes there is a negative contrast (pneumatization).

Functional immaturity – makeieva tube – otherwise normal newborns, frequently in mothers with diabetes:

• there is vomiting, meconium does not depart, there is aboelnaga obstruction of the intestine up to the obstruction,
• dilatation of the ascending and transverse colon, small intestine,
• pseudotumor in the rectum – no.,
• sometimes, when you try to irrigate leaves the tube.

Makarieva obstruction

Obstruction of the small intestine in the newborn (Meaney ileus) is caused by excessively thick meconium.

Meconium is the bowel contents of the fetus, formed from the epithelial cells of the bile coloring (black and green) and mucus.

Meaney ileus develops on the basis of the obstruction throughthe bowel of meconium, mainly in the ileum. Abnormally viscous meconium sticks firmly to the wall of the intestine and closes the lumen. Complications include perforation of the ileum, Meaney peritonitis, volvulus and atresia or stenosis. 90% of young patients with this problem have cystic fibrosis.

Syndrome meconial tube is a temporary obstruction of the distal colon and rectum "stopper" of concentrated meconium. Cause is neuromuscular, intestinal immaturity, which leads to temporary retention and concentration of meconium.

The treatment is conservative.

The problem is more common in children of women with diabetes mellitus and preterm neonates. Could be a sign of Hirschsprung's disease.

Meconium mainly out within 24 hours after birth. In the case of fetal hypoxia can move before the birth, the result is muddy amniotic fluid.

Reasons

Excessively thick and sticky meconium stuck to the intestinal wall in the ileum, closing the passage. Gut over this obstacle is extended, followed by narrow, filled with small lumps of meconium. In 50% of cases the condition is complicated by the formation of a perforation (tear) of the extended part of the intestine and the formation of peritonitis.

Symptoms

• insufficient release of meconium and stool,
• vomiting,
• cystic fibrosis, often present in family history,
• the most significant symptom is a strong swelling (dilatation) of the stomach,
• the symptoms are a sudden stroke of the abdominal cavity.

Diagnostics

• History – important information about cystic fibrosis in the family, polyhydramnios, premature birth, meconium violation of the waste.
• The clinical picture of the child vomiting, distended abdomen, constipation.
• Radiograph of the abdominal cavity – enhanced loop of the small intestine, the characteristic pattern of "milk glass" in the right lumbar region.
• Contrast irrigations examination is important to confirm the diagnosis.

Treatment

The goal of treatment is to remove thickened meconium from the intestinal lumen and thereby in the prevention of possible complications.

Standard supportive care. You must enter a gastric tube, to provide fluid support and prophylactic antibiotics, due attention be paid to the treatment of disorders of the internal environment, to optimize the external factors (temperature and humidity).

Conservative treatment. With early diagnosis are conducted intestinal lavage with the use of contrast agents and mucolytics. Sometimes you have to repeat lavage several times within a reasonable period interval. Conservative treatment is successful in 60% of cases.

Surgical treatment. It runs in a complex meconium ileus or failure of conservative treatment.

Forecast

For children with uncomplicated ileus, the prognosis is good. The quality of life of children is limited to the underlying disease called cystic fibrosis that is present in most young patients with meconial obstruction.

Pylorostenosis

Pyloric stenosis is a thickening of the circular muscle at the transition of the stomach into the duodenum, which becomes an obstacle to the receipt of food from the stomach into the small intestine. The most common age for the development of the disease in infants is 3 to 6 weeks of life (average about 2 months).

3 times more common in boys, often we are talking about original breastfed children.

Symptoms

Clinically pyloric stenosis manifested by vomiting of stomach contents, which, as a rule, follow immediately after feeding. The child is hungry, eats with appetite, but basically all eaten spewing. Could be constipation, or the so-called empty chair. Symptoms begin to appear slowly, gradually becoming more severe vomiting, frequent (after every meal), the child is not gaining weight.

Treatment

Diagnosis is determined by ultrasound, the solution is only surgical, as there is an acute situation. The surgery is performed under General anesthesia, the principle of operation is to cut the hypertrophied muscles to ensure movement through the appropriate part of the digestive tract.

After surgery, the child is quickly restored, and soon adapted to the regular consumption of milk normal portions, relapse usually occurs. Sometimes in the first few days after surgery remains moderate vomiting, caused by swelling of the treated area, but it quickly subsides.

Hospital stay usually lasts from a week to 10 days.

Intussusception

Invagination is the insertion of one part of the intestine with its blood vessels in the neighboring segment. The result is bowel obstruction and, at the same time, insufficient blood supply to the affected part. 95% this problem occurs in the junction of the small and large intestine.

Usually, the affected group are children from 6 months to 2 years (70%).

Diagnostics

The disease is diagnosed sonographically.

Intussusception sudden paroxysmal severe pain in the stomach, the child becomes pale, may also experience excessive sweating. The pain characterized by short duration, 10-15 seconds, often occurs during sleep, and then subsides,the child again falls asleep, but after 10-15 minutes again waking with the same pain. Gradually the pain becomes more intense, and the calm intervals may be reduced.

Vomiting is not a prerequisite, it may be missing. The main diagnostic criterion is the departure of mucus with blood (the stool has the appearance of a raspberry jelly).

Treatment

The solution is hospitalization, in a favorable case it is possible to carry out the procedure of the special enema to the injured section under General anesthesia. If there is no improvement or there are significant violations of the blood supply to the affected area, need for surgery, because there is danger to life of the child.

This disease can recur, particularly among older children.