Intestinal obstruction is a complete or partial inability to move the contents through the digestive tract. It appears when there is a violation of the peristalsis of the intestinal walls. The disease is often found in children, causing severe abdominal pain, and often requires surgery. Lack of immediate assistance leads to death. Why does intestinal obstruction occur in a child and how not to miss it? These and other questions will be discussed in this article.
Different classifications of intestinal obstruction
All types of acute intestinal disorders are divided into two groups: mechanical and dynamic obstruction. The first is when there is a mechanical obstruction (torsion or compression from the outside of the intestines, neoplasm, etc.) at the level of the large or small intestine. It is subdivided into:
- Mixed - the introduction of one gut into another.
- Obstructive - a mechanical obstruction is located in the intestinal lumen. More oftenthe whole reason for this phenomenon is colon cancer, foreign bodies, gallstones.
- Strangulation - is formed by twisting or squeezing the intestine along with the mesentery. The reason is volvulus, strangulation and nodulation of a hernia.
In case of dynamic obstruction, motor function fails due to:
- persistent spasm of the intestinal wall;
- decrease in tone and inability to contract the muscle cells of the intestinal walls.
By level of obstruction:
- small intestine high and low;
- colonic.
Downstream:
- acute and chronic;
- partial and full.
By origin:
- congenital:
- acquired.
The type of intestinal obstruction in a child, which is determined by the doctor through examination, depends on the tactics of treatment.
The development of intestinal obstruction is divided into three stages:
- First - lasts several hours, the patient has flatulence and pain in the abdomen.
- Second - the symptoms are decreasing, but this is a temporary phenomenon. During this period, the child's body is subjected to a powerful intoxication attack. In time, this stage lasts several days.
- Third - terminal.
Causes of intestinal obstruction
The causes of intestinal obstruction in a child depend on age. In newborns, it is caused by a failure in the formation of some internal systems during intrauterinedevelopment. Often such a diagnosis is made in the first days after the baby is born. In older babies, an abnormal process occurs against the background of a genetic predisposition, diseases, or the consequences of the negative impact of external factors.
Provocative reasons:
- prolapse of part of the intestine in infants;
- complications after abdominal surgery;
- medication overdose;
- damage to the body by parasites, including worms;
- adhesions in the gastrointestinal tract;
- congenital anomalies of internal organs;
- malfunction of the biliary tract;
- penetration of foreign bodies into the esophagus;
- malnutrition;
- progression of oncological pathologies and inflammatory processes;
- intestinal volvulus.
Thus, with congenital intestinal obstruction, the cause of the disease is associated with an anomaly in the development of the gastrointestinal tract. Some babies develop it before birth. As a result, the baby is born already with this pathology.
When acquired intestinal obstruction is most common mechanical form. Less often - due to the presence of adhesions. Multiple adhesive intestinal obstruction in children is typical for babies from birth to a year. This type of blockage is accompanied by vomiting, acute pain. This state occurs suddenly.
However, in most cases, the cause of intestinal obstruction is unknown. Most often in children, it manifests itself in the autumn-winter period withSARS diseases. In this regard, there is an opinion that its occurrence is associated with exposure to viruses that cause colds.
Risk factors for intestinal obstruction
Risk factors for bowel obstruction include:
- Gender - most often it is diagnosed in boys.
- Age - younger children are more prone to this ailment. Most often, symptoms of intestinal obstruction are diagnosed in children from one to three years old.
- Heredity - if there were cases of this disease in the family, then the child has a high risk of developing it.
- History of intestinal obstruction - if the baby has already suffered this pathology, then he is at re-risk of its development.
- Abnormal formation of the gastrointestinal tract - the intestine does not develop or does not wrap properly.
Clinical picture in children of different ages
How to understand that a child has intestinal obstruction? The first symptom is sudden and loud crying, which is caused by severe pain in the abdomen. Babies up to a year pull their legs to their chest while crying. The pain is transient, that is, the attack is repeated every twenty minutes. In the future, the duration of the pain syndrome increases, and the interval between it decreases. In addition, such a phenomenon is always preceded by symptoms:
- stool retention;
- bloating;
- severe pain caused by spasms.
If a child has the above symptoms, it is urgent to seek medical help. Untimelycare provided increases the risk of death.
Signs of intestinal obstruction develop, as already mentioned, gradually. In general, the clinical picture is as follows:
- vomit;
- signs of dehydration;
- sharp pain in the abdomen;
- colic;
- flatulence;
- constipation;
- vomit mixed with feces;
- increased salivation;
- temperature increase;
- lack of appetite;
- bloody spots in scanty stools;
- decrease in daily urine output;
- rapid breathing and heartbeat;
- bloating;
- seal in the abdominal region;
- absence of normal stool for a long period.
With a congenital form of intestinal obstruction in infants, symptoms appear as early as the third day after birth. This is:
- lack of defecation and exit of the original feces or in other words, meconium, during the day after the baby was born;
- vomiting after feeding;
Accompanied by intestinal obstruction with severe crying and pain. This is due to malformations of organs located in the abdominal cavity:
- compression of the intestinal cavity or infringement in the opening of the intestinal wall;
- spasm or impotence (weakness) of the intestines.
If such failures are accompanied by dense and rather thick primordial meconium, then the contents of the intestine are not able to move along the passage. SoThus, the newborn does not have a meconium discharge. This situation leads to the death of intestinal tissues, perforation of the intestine, and then to blood poisoning and death. Most of the malformations of the intestines are laid in the first trimester of pregnancy.
Symptoms of intestinal obstruction in children under one year old:
- vomit;
- flatulence;
- mucus with blood splashes comes out of the rectum, no feces;
- abdominal tightening;
- passing pain of paroxysmal nature.
When the lower intestine is clogged, the stomach is very swollen and hurts, vomiting with the smell of feces.
Partial intestinal obstruction is formed when the intestinal lumen is not completely blocked. In such a situation, part of the feces is able to move towards the exit. The disease manifests itself with the following symptoms:
- nausea, vomiting;
- pain syndrome is less pronounced than with complete obstruction;
- bloating.
Symptoms of intestinal obstruction in a child at the age of 5 are manifested by a sharp pain attack and vomiting. The chair is absent, the stomach is swollen. Children behave restlessly, try to take a comfortable position to relieve pain. There are blood spots in the stool. On palpation, the abdomen is firm. Similar signs are typical for children from a year old.
Conservative therapy. When is it effective?
Conservative treatment of symptoms of intestinal obstruction in a child at 6 years of age or in children in a different age category is possible withpartial intestinal obstruction, when the intestinal lumen is not completely blocked and some part of the feces is able to come out.
Doctors call the first six hours of the development of this pathology "golden", that is, this is the time when it can be cured without surgical intervention. Activities carried out by physicians with partial blockage of the intestine:
- probe insertion;
- ganglionic blockade;
- washing;
- intravenous stimulation with special solutions;
- siphon enema, which is placed forty minutes after the above manipulations.
From medicines for the treatment of symptoms of intestinal obstruction in children, drugs are allowed that normalize the general condition and improve the movement of feces. Among them:
- Prozerin.
- "Drotaverine", "Papaverine".
- Fitomucil.
- Metoclopramide, Domperidone.
- Suppositories with glycerin.
Introduction of intravenous saline solutions to maintain water-s alt balance. The goal of pharmacotherapy is to eliminate stagnation in the intestines and exclude poisoning of the child's body.
Surgical intervention as one of the types of treatment
Most often, the only chance to save the patient is an operation, the type of which depends on the cause that provoked the disease. Surgical treatment of symptoms of bowel obstruction in children is indicated if more than twelve hours have passed since the onset of initial signs, there is evidence of a congenital anomaly, a high risk of recurrence, orforeign body or mechanical barrier detected. Perform the following manipulations:
- Remove part of the dead gut and sew the rest together.
- With a hernia - it is sutured and the intestine is set. If the tissues are alive, then removal is not carried out.
- Straighten the noose during volvulus.
- Foreign body removed.
After surgery, a small patient is prescribed antibacterial or anti-inflammatory drugs, as well as saline solutions to stabilize the condition.
Treatment with alternative medicine
To relieve signs of intestinal obstruction in a child in the initial stage of the disease, it is allowed to use traditional medicine methods, but strictly in agreement with the attending pediatric surgeon. It is advisable to use them only with partial obstruction. Self-treatment, that is, without consulting a specialist, is fraught with a threat to the he alth of the baby. The most popular options are:
- Fresh cucumbers, melon, pineapple, tomatoes, peaches, prunes - have a laxative effect.
- Juice of one plum in the ratio 1:1 is diluted with water. Take two tablespoons before meals.
- Pumpkin porridge and puree.
- Sea buckthorn oil is added to compote or tea, three times a day, half a teaspoon is given to the child.
- Mixed in equal parts, pre-chopped figs, dried apricots, prunes and raisins, add a small amount of honey. Give the baby several times a day for a teaspoon.
Diet food. Why is it important to observe it?
After an operation for intestinal obstruction in a child of 5 years or at another age, the children are shown dietary nutrition for a long period. This forced measure contributes to the normalization of digestion and restores bowel function. It has been proven that one in four cases of this disease is caused by malnutrition.
It is important to remember that when the intestine is blocked (in the acute phase), any meal is contraindicated for the baby. During the first day after the operation, they are also not fed, on the second day they are given liquid food. For intestinal obstruction, doctors recommend:
- Eat small meals eight times a day.
- All food is ground to a mushy state and eaten warm.
- Calorie content during the first days - 600, up to 1000 kcal - seven days after the operation.
The following products are allowed:
- jelly;
- jelly;
- porridge;
- mucus decoctions;
- sour milk;
- fruit jelly;
- low-fat poultry broth;
- mashed vegetables;
- omelette;
- steam meatballs.
Products that cause fermentation are prohibited throughout the year. In addition, s alt intake is limited. Non-compliance with the diet increases the risk of recurrence of the disease.
Prevention measures
There are situations in which it is not possible to prevent intestinal obstruction. For example, if children have congenitalintestinal obstruction or there is a progression of another disease that contributes to the blocking of the intestinal lumen. However, even in such cases, doctors recommend adhering to the following recommendations:
- diet control;
- timely removal of polyps, adhesions in the intestine;
- if the baby complains of pain in the abdomen and he has nausea or vomiting, then you need to see a doctor;
- if the frequency of defecation and urination in a child has decreased, then this is also a reason to visit a doctor;
- regular preventive check-ups, including from specialists.
Consequences and complications of the disease
The most terrible complication of intestinal obstruction in a child is death. With the progression of the anomaly, the body undergoes intoxication. The blood supply to the digestive organs is significantly disrupted, as a result, the tissues of the intestinal wall are destroyed and die. Both toxins and water and nutrients stop entering the bloodstream. Such phenomena, together with vomiting, lead to dehydration of the body, sometimes even surgery is powerless. Death occurs within a day after the first symptoms of blockage appear, i.e. nausea and feeling unwell.
In addition, there are other, less dangerous, but rather serious complications: kidney failure, severe dehydration, failure of vital systems.
Instead of a conclusion
Intestinal obstruction in a child of 6 years or other age is considereddangerous pathology. The success of treatment depends on the speed of delivery of a small patient to a physician. According to statistics, the operation within the first six hours after blockage ends with a complete recovery, and after a day it has about twenty-five percent of deaths. Thus, if an ailment is detected, or even just if an obstruction is suspected, urgent specialist help is required.
