Invagination of the intestine in children: studies and practice

Authors

DOI:

https://doi.org/10.15574/PS.2022.77.101

Keywords:

intestinal intussusception, intussusception simulators, training

Abstract

Intestinal invagination is a mixed form of intestinal obstruction that occurs when one section of the intestine is telescopically immersed in the lumen of another and occurs mainly at the age of 3 months to 1 year, which is 90%, and mortality, according to the literature, ranges from 6 to 14.5%.

Despite a sufficient number of scientific and clinical publications on the pages of medical journals regarding the diagnosis and treatment of intestinal intussusception, there are no fake simulators in the training of students and interns, which determines the relevance of this publication.

Purpose - to improve the results of diagnosis and treatment of children with intestinal intussusception by analyzing domestic developments and visually studying the mechanism of its development with the help of a simulator both for the purpose of diagnosis and treatment - conservative disinvagination.

Results. In today’s conditions, general practitioners and pediatricians are not trained to diagnose intussusception in children, that is, they do not have simple methods of examination. Hospitals usually do not have the equipment to examine and diagnose acute intussusception. In order to eliminate the gaps at the Department of Pediatric Surgery of the Bukovinian State Medical University, a dummy-simulator of intestinal intussusception «Garant» was developed and introduced into the educational process. Training on a simulator allows you to master the practical skills of diagnostics in the conditions of an X-ray room and conservative disinvagination followed by X-ray control. In turn, the development of skills by primary care physicians and pediatric surgeons in diagnosis and treatment will primarily improve the understanding of the onset of the disease and treatment methods.

Conclusions. With certain and significant developments regarding the diagnosis and treatment of intestinal intussusception in children, the problem has not been solved, since some children seek help at the wrong time, and as a result of complications - necrosis, peritonitis with organ and multiple organ failure. The use of a scoring system for assessing the stage of invagination makes it possible to systematize the main prognostic indicators of sonographic and dopplerographic studies in order to determine an adequate method of treatment. Practicing the skills of diagnosis and treatment on the self-developed dummy «Garant» allows you to clearly understand the essence and purpose of the measures taken to establish and confirm the diagnosis of intestinal intussusception, evaluate the possibilities of various methods of conservative and surgical treatment and indications for them.

No conflict of interests was declared by the authors.

Author Biography

P.S. Rusak, Shupyk National Healthcare University of Ukraine, Kyiv

Zhytomyr Regional Children’s Clinical Hospital, Ukraine

References

Apelt N, Featherstone N, Giuliani S. (2013). Laparoscopic treatment of intussusception in children: a system-atic review. J. Pediatr. Surg. 48 (8): 1789-1793. https://doi.org/10.1016/j.jpedsurg.2013.05.024; PMid:23932624

Blinman T, Ponsky T. (2012). Pediatric minimally invasive surgery: laparoscopy and thoracoscopy in infants and children. Pediatrics. 130 (3): 539-549. https://doi.org/10.1542/peds.2011-2812; PMid:22869825

Dehtiar VA, Zaporozhchenko AH, Bondariuk LN y dr. (2011). Maloynvazyvnye metody lechenyia ynvahynatsyy kyshechnyka u detei. Khirurhiia dytiachoho viku. 8 (1): 52-53.

Fallon SC, Lopez ME, Zhang W et al. (2013). Risk factors for surgery in pediatric intussusception in the era of pneumatic reduction. J. Pediatr. Surg. 48 (5): 1032-1036. https://doi.org/10.1016/j.jpedsurg.2013.02.021; PMid:23701778

Hill SJ, Koontz CS, Langness SM, Wulkan ML. (2013). Laparoscopic versus open reduction of intussusception in children: experience over a decade. J. Laparoendosc. Adv. Surg. Tech. A. 23 (2): 166-169. https://doi.org/10.1089/lap.2012.0174; PMid:23327343

Hrytsenko NY. (1986). Sposob lechenyia tonkokyshechnoi ynvahynatsyy u detei. Avtorskoe svydetelstvo SSSR No.1491469. Zaiavka No.4150276. Pryorytet yzobretenyia, 21 oktiabria 1986 hoda.

Hrytsenko YeM, Hrytsenko MI. (2005). Sposib pidtverdzhennia dezinvahinatsii pry konservatyvnomu likuvanni invahinatsii kyshechnyku u ditei. Patent Ukrainy na korysnu model No.7013. zaiavka No.20040402965. Podano 21.04.2004, zatverdzheno 15.06.2005, opublikovano 15.06.2005, biul. No.6.

Hrytsenko YeM, Hrytsenko MI. (2005). Sposib pidtverdzhennia dezinvahinatsii pry konservatyvnomu likuvanni invahinatsii kyshechnyku u ditei. Patent Ukrainy na korysnu model No.7014. Zaiavka No.20040402967. Podano 21.04.2004, zatverdzheno 15.06.2005, opublikovano 15.06.2005. biul. No.6.

Hrytsenko YeM, Hrytsenko MI. (2005). Sposib pidtverdzhennia dezinvahinatsii pry konservatyvnomu likuvanni invahinatsii kyshechnyku u ditei. Patent Ukrainy na korysnu model No.7015. Zaiavka No.20040402970. Podano 21.04.2004, zatverdzheno 15.06.2005, opublikovano 15.06.2005, biul. No.6.

Kryvchenia DIu, Lysak SV, Plotnykov OM. (2008). Khirurhichni zakhvoriuvannia u ditei. Vinnytsia: PP «Nova knyha»: 253.

Kukuruza YuP, Pohorilyi VV, Navrotskyi VA ta in. (2011). Uskladnennia ta rezultaty konservatyvnoho i operatyvnoho likuvannia invahinatsii u ditei. Khirurhiia dytiachoho viku. 8 (1): 47-49.

Lorens S et al. (2013). A multi-country study of intussusception in children under 2 years of age in Latin America: analysis of prospective surveillance data. BMC Gastroenterology. 13: 95. https://doi.org/10.1186/1471-230X-13-95; PMid:23710610 PMCid:PMC3672009

Reilly NR, Aguilar KM, Green PH. (2013). Should intussusception in children prompt screening for celiac disease? J. Pediatr. Gastroenterol. Nutr. 56 (1): 56-59. https://doi.org/10.1097/MPG.0b013e31826a1099; PMid:22832512

Rusak PS, Danylov OA, Kukuruza YuP, Rybalchenko VF. (2006). Laparoskopichna khirurhiia dytiachoho viku. Navchalno-metodychnyi posibnyk. Zhytomyr-Kyiv: NMAPO im. P.L. Shupyka, VNMU im. M.I. Pyrohova: 128.

Rusak PS, Rybalchenko VF, Stakhov VV, Shevchuk DV, Marchenko VF, Zaremba VR, Daleka MV. (2016). Sposib likuvannia invahinatsii kyshechnyku u ditei. Patent Ukrainy na vyna-khid No.112045 UA vid 11.07.2016.

Rusak PS, Rybalchenko VF, Stakhov VV, Shevchuk DV, Marchenko VF, Zaremba VR, Daleka MV. (2016). Sposib likuvannia invahinatsii kyshechnyku u ditei. Patent Ukrainy na korysnu model No.107441 UA. Opublikovano 10.06.2016.

Rybalchenko VF. (2007). Neprokhidnist ileotsekalnoho kuta u ditei. V.F. Khirurhiia dytiachoho viku. 4 (2): 20-30.

Rybalchenko VF. (2013). Analiz roboty dytiachoi khirurhichnoi sluzhby Ukrainy u 2012 rotsi. Khirurhiia dytiachoho viku. 3: 24-33. URL: http://nbuv.gov.ua/UJRN/Khdv_2013_3_8.

Solovev AE. (2009). Stadyy ynvahynatsyy kyshok u detei. Khirurhiia dytiachoho viku. 1: 41-43.

Stakhov VV. (2016). Kryterii diahnostyky ta osoblyvosti likuvalnoi taktyky pry invahinatsii kyshechnyka u ditei. Khirurhiia dytiachoho viku. 3-4: 42-50. https://doi.org/10.15574/PS.2016.52-53.42

Zhang Y, Bai YZ, Li SX et al. (2011). Sonographic findings predictive of the need for surgical management in pediatric patients with small bowel intussusceptions. Langenbecks Arch. Surg. 396 (7): 1035-1040. https://doi.org/10.1007/s00423-011-0742-6; PMid:21274558

Published

2022-12-27

Issue

Section

Training of medical personnel