Why is the surgery being performed? Intussusception can cause reduced blood flow to part of the bowel, which would stop it functioning properly and can also lead to problems with infection. The effects of intussusception, like dehydration due to vomiting, can become serious quite quickly in children, so the condition needs emergency treatment.
Anatomical explanation of surgery (diagram):
If your child is not well enough to have an enema, or if the enema did not reduce the intussusception, your child will need an operation under general anaesthetic.
Your child’s surgeon will gently squeeze the bowel to push out the inner segment. He or she will also examine the bowel to see if there is blood flow to that part of the bowel and if it looks healthy.
The surgeon will remove any part of the bowel where tissue has died due to the lack of blood flow. The amount can vary, but the surgeon will leave as much bowel as possible.
Any special test before surgery: An enema is usually the first treatment. A tube is inserted into your child’s bottom and air or oxygen is released into the bowel. This works by expanding the bowel, so that the intussusception corrects itself. If the enema works well, you will be able to return home in a day or so.
Preparations before surgery: If your child is dehydrated, he or she will need a drip of fluids for a while before treatment starts. Your child will also need a nasogastric tube, which is passed up the nose, down the food-pipe and into the stomach. This will drain off the stomach and bowel contents, and ‘vent’ any air that has built up, which will make your child more comfortable.
Risk of surgery: All surgery carries a small risk of bleeding during or after the operation. There is a chance that the bowel could be damaged during the operation, but this is very rare. If bowel damage occurs, this can be fixed in the same operation.
Care during Hospitalization:
Your child will come back to the ICU to recover.
For the first 48 hours after the operation, we will monitor your child closely. He or she may be connected to monitors to check his or her breathing, heart rate and oxygen levels. Your child will have been given pain relieving medications during the operation, but these will begin to wear off. For the first few days, pain relief will usually be given through a ‘drip’ and then, when your child is more comfortable, in the form of medicines to be swallowed.
Your child will not be able to feed during this period, to allow the bowel to recover. He or she will continue to have a drip of fluids and the nasogastric tube to drain off the stomach contents.
After a couple of days, your child will be able to feed again, starting with small amounts and increasing the amount as he or she tolerates it. When your child’s bowel has recovered completely, you will be able to feed him or her solids. The doctors will let you know when this is likely.
Your child will be able to go home once he or she is feeding well. This is usually a week or so after the operation.
Care at Home:
Diet: Usually liquid to semisolid diet for the 1st week after surgery
Bath: When your child has a bath, do not soak the area until the operation site has settled down.
Care of incision: Your child’s abdomen may feel sore for a while after the operation, but wearing loose clothes can help. The stitches used during the operation will dissolve on their own so there is no need to have them removed. If possible, keep the operation site clean and dry for two to three days to let the operation site heal properly.
Activity: Distract your child by playing games, watching TV or reading together can also help to keep your child’s mind off the pain.
Medications: Your child will need to have regular pain relief for at least three days, and we will give you the medications to take home with you
Symptoms to report to your physician. (Call your doctor when)
your child is in a lot of pain and pain relief does not seem to help
your child is not keeping any fluids down or has signs of dehydration
your child has a high temperature of 37.5°C or higher, and paracetamol does not seem to bring it down
the operation site is red or inflamed and feels hotter than the surrounding skin
there is any oozing from the operation site
your child has any signs that the intussusception has returned such as:
blood and mucus in faeces
Follow-up: You may need to come back to hospital for an outpatient appointment 1 week after the operation