From the Guidelines
The most common cause of intestinal obstruction in pediatrics is intussusception (option B). Intussusception occurs when one segment of intestine telescopes into an adjacent segment, leading to obstruction of the bowel lumen. This condition typically affects children between 3 months and 3 years of age, with peak incidence around 5-10 months [ 1 ]. Patients often present with intermittent, colicky abdominal pain, vomiting, and sometimes "currant jelly" stools (bloody mucus). The classic triad of abdominal pain, vomiting, and bloody stools is present in only about 20-40% of cases. Most cases of intussusception in children are idiopathic, though some may be associated with viral infections, Meckel's diverticulum, or intestinal lymphoid hyperplasia. Peyer's patches (option A) are aggregated lymphoid nodules found in the small intestine that can become hyperplastic during infections but are not themselves a primary cause of intestinal obstruction [ 1 ].
Some key points to consider in the diagnosis and management of intussusception include:
- Early diagnosis and treatment of intussusception is crucial, with air or hydrostatic enema being both diagnostic and therapeutic in many cases [ 1 ].
- Surgical intervention may be necessary if non-operative reduction fails or if there are signs of peritonitis or perforation.
- Intussusception can be associated with other conditions, such as viral infections or Meckel's diverticulum, and a thorough clinical evaluation is necessary to determine the underlying cause [ 1 ].
- The clinical presentation of intussusception can vary, and a high index of suspicion is necessary to make the diagnosis, especially in young children [ 1 ].
In terms of morbidity, mortality, and quality of life, early diagnosis and treatment of intussusception is essential to prevent complications and improve outcomes [ 1 ]. Delayed diagnosis or treatment can lead to increased morbidity and mortality, as well as long-term complications such as bowel obstruction or perforation. Therefore, it is critical to prioritize early recognition and management of intussusception in pediatric patients.
From the Research
Causes of Intestinal Obstruction in Pediatrics
- The most common cause of intestinal obstruction in pediatrics is intussusception, as stated in studies 2, 3, 4, 5, 6.
- Intussusception is a condition where a part of the intestine invaginates into another part, causing obstruction, and it is the most common cause of acute intestinal obstruction in infancy 3.
- Idiopathic intussusception is one of the most common causes of small bowel obstruction in children 4.
Diagnosis and Treatment
- Radiology plays a key role in the diagnosis and treatment of intussusception, with ultrasound being the preferred imaging modality due to its high diagnostic accuracy and lack of ionizing radiation 2.
- Non-surgical treatment options, such as pneumatic or hydrostatic reduction, are available and have been shown to be effective in reducing intussusception 3, 5.
- Surgical treatment may be necessary in cases where non-surgical reduction fails, and laparoscopy has been shown to be a safe and effective surgical technique for the treatment of pediatric intussusception 4.