Intussusception
Definition
In case of entry of the ileum with its mesentery into the colon
intussusception resulting in a mechanical bowel obstruction.
Objectives
• To open the abdomen to
inspect the bowel
• To
reduce the intussusception and relieve obstruction
• To
resect and anastomose, if the bowel has become gangrenous.
Position
Supine.
Anesthesia
General with endotracheal intubation.
Procedure
1. Right transverse upper abdominal 7-8 cm long incision.
2. Avoid the subcutaneous tissues and muscles.
3. Open the peritoneal cavity.
4. Identify the intussusception mass.
5. Suck out the peritoneal fluid, if any.
6. Reduce the intussusception by “milking” from
distal to proximal side, without injury to the bowel.
7. Resect and anastomoses the bowel, if it fails
to reduce completely or found gangrenous.
8. Check for free flow of intestinal contents.
9. Check for any associated lesion, i.e. lymphoma
Meckles diverticulum.
10. Close the abdominal wound in layers.
Instruments
General pediatric set.
Sutures
• Catgut 2/0, 3/0, 4/0
• Silk
3/0, 4/0
• Nylon
4/0
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