Intussusception in Children with Signs of Peritonitis
When a child presents with intussusception accompanied by signs of peritonitis, the clinical picture demands prompt surgical evaluation. This specific scenario guides the choice of operative approach and intraoperative decision-making.
Clinical Scenario
Children with intussusception who present with signs of peritonitis represent a subset requiring operative management rather than non-operative reduction alone. The presence of peritonitis alters both the urgency and the surgical strategy.
Treatment Approach (partial overview)
Management is operative. In a hemodynamically stable patient, a minimally invasive surgical approach may serve as the starting point — though intraoperative findings, including the state of the involved bowel, will shape subsequent decisions. The complete protocol specifies the full surgical algorithm and additional intraoperative considerations.
References
DOI: 10.1016/j.jpedsurg.2020.09.055
- Signs of peritonitis
- If patient is hemodynamically stable, start with laparoscopic reduction
- Consider intraoperative use of air or saline enema to facilitate reduction
- Consider removing the appendix in setting of inflammation or ischemia
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