Intussusception_Flashcards
What is the initial approach for managing intussusception?
The ABCDE approach.
What supportive treatments may be needed for intussusception?
IV fluids and NG tube aspiration may be needed.
What is the usual method attempted by a radiologist to reduce intussusception if there are no signs of peritonitis?
Reduction of the intussusception by rectal air insufflation with fluoroscopy guidance.
What is the success rate of rectal air insufflation for reducing intussusception?
75%
What percentage of intussusception cases require an operation after an unsuccessful rectal air insufflation?
25%
What are the contraindications to contrast enema reduction for intussusception?
Peritonitis, perforation, and hypovolaemic shock.
What broad-spectrum antibiotics may be used in the management of intussusception?
Clindamycin + gentamicin OR tazocin OR cefoxitin + vancomycin.
What is the second-line treatment if contrast enema reduction fails or is contraindicated?
Surgical reduction with broad-spectrum antibiotics.
When is immediate laparotomy indicated in the management of intussusception?
If there is peritonitis or perforation.
What should be considered if there is recurrent intussusception?
Investigating for a pathological lead point (e.g. Meckel’s diverticulum).
How can lifestyle and diet modifications help manage Irritable Bowel Syndrome (IBS)?
Ensuring sufficient intake of fluids, eating regularly, limiting fresh fruit intake, reducing intake of ‘resistant starch’ and insoluble fibre, reducing stress, identifying precipitating substances such as caffeine, lactose or fructose, adding fibre and probiotics to the diet, adhering to the FODMAP diet, and considering referral to a dietician.
What medications can be considered for severe IBS symptoms not responding to non-drug approaches?
Laxatives, antimotility drugs like loperamide hydrochloride, and antispasmodic drugs.
What should be explained to parents about the cause of intussusception?
Intussusception is caused by telescoping of the bowel and typically occurs in young children.
How should the procedure for reducing intussusception be explained to parents?
A small, soft tube will be placed a short way into the child’s back passage, through which air will be passed. The doctor will monitor the child’s bowel with an x-ray to check if the blockage is reversed.
What should be explained about the possibility of needing an operation for intussusception?
There is a 75% success rate with rectal air insufflation, but an operation may be needed if it is unsuccessful.
