nvagination một phần của ruột vào bản thân. A: Nguyên nhân chưa được biết trong nhiều trường hợp. Có thể phức tạp nhiễm siêu vi như viêm tai giữa, viêm dạ dày ruột, hoặc URTIs; sưng Peyer của các bản vá lỗi trong hồi tràng có thể kích thích nhu động ruột gây ra một lồng ruột. | Intussusception 97 D Invagination of part of the intestine into itself. A The cause is unknown in most cases. May complicate viral infections such as otitis media gastroenteritis or URTIs swollen Peyer s patches in the ileum may stimulate peristalsis causing an intussusception. In 2-10 a lead point for the intussusception is found . inverted appendiceal stump Meckel s diverticulum an intestinal polyp or adhesions from recent surgery. A R HSP CF patients are at risk if they become dehydrated. _E 1-4 1000 births. M F 4 1. It is the most common cause of intestinal obstruction between 3 months and 6 years of age. 60 are 1 year 80 occur before 2 years. Peak age 6-9 months. Rare in neonates. _H Classically present with a triad of symptoms 1 Vomiting is the most common symptom initially non-bilious and reflexive then becomes bilious. 2 Colicky severe and intermittent pain associated with screaming and often pallor. The child is often reported to draw legs up to the abdomen may appear well or lethargic in between episodes. 3 Red currant jelly stools occur in only one-third of cases. Note may present with only lethargy and poor feeding. E Abdomen soft and non-tender in early stages but eventually abdomen becomes distended and tender. May find sausage-shaped mass in the right side of the abdomen or blood on rectal examination. _P The most common site of invagination is the terminal ileum into the caecum. Constriction of the mesentery obstructs venous return which engorgement and oedema with subsequent bleeding. If the obstruction is not relieved engorgement will prevent arterial perfusion that results in intestinal infarction and perforation. Bloods WCC late sign CRP U Es. AXR look for dilated small bowel and absence of gas in the region of the caecum. Barium air water-soluble contrast enema diagnostic and curative in 75 of children. M Reduction is an emergency. Therapeutic enema using barium air or water-soluble contrast pressure can be gradually to force back the
