Intestinal obstruction is the complete or partial impossibility of promoting the contents of the digestive tract. It appears with a violation of the peristalsis of the intestinal walls. The disease is often found in children, causing severe pain in the abdomen, and often requires surgical intervention. Lack of immediate assistance is fatal. Why does intestinal obstruction occur in a child and how not to miss it? These and other issues 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 obstacle (inversion 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 lumen of the intestine. Most often, the cause of this phenomenon is colon cancer, foreign bodies, gallstones.
- Strangulation - is formed by twisting or squeezing the intestine along with the mesentery. The reason is inversion of the intestines, infringement and nodulation of the hernia.
In case of dynamic obstruction, the motor function fails due to:
- persistent spasm of the intestinal wall;
- decreased tone and inability to reduce muscle cells of the intestinal wall.
According to the level of obstruction:
- small intestine high and low;
- colonic.
With the flow:
- acute and chronic;
- partial and complete.
By origin:
The tactics of treatment depend on the type of intestinal obstruction in the child, which the doctor determines by examination.
The development of intestinal obstruction is divided into three stages:
- The first one takes several hours in duration, the patient has flatulence and pain in the abdomen.
- The second - the symptoms are reduced, 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.
- The third is terminal.
Causes of intestinal obstruction
Causes of intestinal obstruction in a child depend on age. In newborns, it is caused by a malfunction in the formation of some internal systems during fetal development. 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, disease, or the consequences of the negative effects of external factors.
Provocative reasons:
- prolapse of part of the intestines in infants;
- complications after surgery on the abdominal organs;
- Excessive medication
- damage to the body by parasites, including worms;
- adhesions in the digestive tract;
- congenital malformations of internal organs;
- failure of the biliary tract;
- penetration of foreign bodies into the esophagus;
- errors in nutrition;
- the progression of oncological pathologies and inflammatory processes;
- volvulus.
Thus, with congenital intestinal obstruction, the cause of the disease is associated with an abnormality in the digestive tract. In some babies, it develops even before birth. As a result, the baby is born already with this pathology.
With acquired intestinal obstruction, the mechanical form is most often found. Less often - due to the presence of adhesions. Multiple adhesive intestinal obstruction in children is characteristic of babies from birth to a year. This type of blockage is accompanied by vomiting, acute pain. This condition 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 with acute respiratory viral infections. 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 intestinal obstruction include:
- Sex - most often it is diagnosed in boys.
- Age - young children are more prone to this ailment. Most often, symptoms of intestinal obstruction in children from one to three years are diagnosed.
- Heredity - if there were cases of this disease in the family, then the child has a high risk of his development.
- An intestinal obstruction in the anamnesis - if the baby has already suffered this pathology, then he is at repeated risk of its development.
- Abnormal formation of the gastrointestinal tract - the intestine does not develop or is improperly wrapped.
The clinical picture in children of different ages
How to understand that a child has bowel obstruction? The first sign is a sudden and loud cry, which is caused by severe pain in the abdomen. Kids up to a year pull their legs to their chest while crying. The pain is transient in nature, 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, this phenomenon is always preceded by symptoms:
- stool retention;
- bloating;
- severe pain caused by cramping.
If the child has the above symptoms, then it is urgent to seek help from doctors. Untimely help increases the risk of death.
Signs of intestinal obstruction develop, as already mentioned, gradually. In general, the clinical picture is as follows:
- vomiting
- signs of dehydration;
- sharp pain in the abdomen;
- colic
- flatulence;
- constipation;
- vomit mixed with feces;
- increased discharge of saliva;
- temperature rise;
- lack of appetite;
- bloody impurities in lean feces;
- decrease in daily urine volume;
- frequent breathing and palpitations;
- bloating;
- compaction in the abdominal region;
- lack of normal stool for a long period.
With a congenital form of intestinal obstruction in infants, symptoms appear already on the third day after birth. It:
- the absence of bowel movement and the release of the original feces or in another way, meconium, during the day after the appearance of the crumbs in the light;
- vomiting after feeding;
Intestinal obstruction is accompanied by severe crying and pain. This is due to malformations of the organs located in the abdominal cavity:
- squeezing the intestinal cavity or pinching in the opening of the intestinal wall;
- spasm or impotence (weakness) of the intestine.
If such failures are accompanied by a dense and rather dense primordial meconium, then the contents of the intestine are not able to move along the aisle. Thus, the newborn has no meconium discharge. This situation leads to the death of intestinal tissue, perforation of the intestine, and then to blood poisoning and death. Most of the intestinal malformations occur in the first trimester of pregnancy.
Symptoms of bowel obstruction in children up to a year:
- vomiting
- flatulence;
- mucus with blood impregnations comes out of the rectum, feces are absent;
- compaction of the abdomen;
- passing paroxysmal pain.
When the lower intestine is clogged, the stomach is greatly swollen and sore, vomiting with the smell of feces.
Partial intestinal obstruction is formed with incomplete overlap of the intestinal lumen. 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 bowel obstruction in a child at 5 years of age are manifested by a sharp pain attack and vomiting. The chair is absent, the stomach is swollen. Children are anxious, trying to take a comfortable position to relieve pain. Blood feces are present in the feces. On palpation, the abdomen is dense. Similar signs are characteristic of children from one year old.
Conservative therapy. When is it effective?
Conservative treatment of symptoms of bowel obstruction in a child of 6 years old or in children of a different age category is possible with partial intestinal obstruction, when the intestinal lumen is not completely blocked and some part of the feces is able to go outside.
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 doctors with partial blockage of the intestine:
- insertion of a probe;
- ganglionic blockade;
- washing;
- intravenous stimulation with special solutions;
- siphon enema, which is placed forty minutes after the above manipulations.
From medications, 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:
- Proserin.
- Drotaverin, Papaverine.
- "Fitomucil."
- "Metoclopramide", "Domperidone."
- Suppositories with glycerin.
The introduction of intravenous salt solutions to maintain the water-salt balance. The goal of pharmacotherapy is to eliminate stagnation in the intestines and to eliminate poisoning of the child's body.
Surgery as a treatment
Most often, the only chance to save the patient is an operation, the form of which depends on the cause that triggered the ailment. Surgical treatment of symptoms of intestinal obstruction in children is indicated if more than twelve hours have passed from the onset of the initial signs, there is confirmation of a congenital anomaly, a high risk of relapse, or a foreign body or mechanical barrier is found. Perform the following manipulations:
- Part of the dead gut is removed and the remainder is sutured.
- With a hernia, it is sutured and the intestine is set. If the tissues are living, then the removal is not carried out.
- Straighten the loop when the intestines are twisted.
- Remove the foreign body.
After surgery, a small patient is shown antibacterial or anti-inflammatory drugs, as well as saline solutions to stabilize the condition.
Alternative Medicine
To remove signs of intestinal obstruction in a child in the initial stage of the disease, the use of alternative medicine methods is allowed, but strictly in agreement with the treating children's surgeon. It is advisable to use them only with partial obstruction. Self-treatment, i.e., without consulting a specialist, is fraught with a threat to the health of the baby. The most popular options include:
- Fresh cucumbers, melon, pineapple, tomatoes, peaches, prunes - have a laxative effect.
- The juice of one plum in a ratio of 1: 1 is diluted with water. Take two tablespoons before meals.
- Pumpkin porridge and mashed potatoes.
- Sea buckthorn oil is added to compote or tea, three times a day, half a teaspoon is given to the child.
- Mix 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.
Dietary nutrition. Why is it important to comply?
After surgery for bowel obstruction in a child at 5 years old or at a different age, the children are shown diet food for a long period. This forced measure helps to normalize digestion and restores bowel function. It is proved that every fourth case of this ailment is caused by malnutrition.
It is important to remember that with a blockage of the intestine (in the acute phase), any meal is contraindicated for the baby. During the first days after the operation, they are also not fed, on the second - they give liquid food. For intestinal obstruction, doctors recommend:
- Eat small meals eight times a day.
- All food is ground to a mushy state and consumed in a warm form.
- Calories in the first days - 600, up to 1000 kcal - seven days after the operation.
The following products are allowed:
- jelly;
- jelly;
- cereals;
- mucous decoctions;
- spoiled milk;
- fruit jelly;
- low-fat poultry broth;
- mashed vegetables;
- omelette;
- steam meatballs.
Fermentation products are prohibited during the year. In addition, salt intake is limited. Failure to diet increases the risk of relapse.
Preventive actions
There are situations in which it is not possible to prevent intestinal obstruction. For example, if children have congenital bowel obstruction or another disease progressing that contributes to the closure of the intestinal lumen. However, 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 should consult a doctor;
- if the child's frequency of acts of defecation and urination has decreased, then this is also an occasion for visiting a doctor;
- regular preventive examinations, including by specialists.
The consequences and complications of the disease
The worst complication of bowel obstruction in a child is death. With the progression of anomalies, the body undergoes intoxication. The blood supply to the digestive organs is significantly impaired, as a result, intestinal wall tissues are destroyed and die. Both toxins and water and nutrients no longer enter the bloodstream. Such phenomena, together with vomiting, lead to dehydration of the body, sometimes even surgical intervention is powerless. A fatal outcome occurs within 24 hours after the onset of the first symptoms of blockage, i.e., nausea and poor health.
In addition, there are other, less dangerous, but rather serious complications: renal failure, severe dehydration, malfunction of vital systems.
Instead of a conclusion
Bowel obstruction in a child at 6 years of age or another is considered a dangerous pathology. The success of treatment depends on the speed of delivery of the small patient to the doctor. According to statistics, the operation within the first six hours after the blockage ends in complete recovery, and a day has about twenty-five percent of deaths. Thus, in identifying an ailment or even simply with suspicion of obstruction, urgent specialist assistance is required.