Causes of intestinal obstruction in the baby
There are many different causes that can cause an intestinal obstruction. Often the cause cannot be clearly determined. However, all causes have in common that the passage of the intestinal contents to the rectum and finally the excretion is hindered or interrupted.
Normally the intestinal contents move in undulating movements, known as peristalsis, in the intestine to the rectum, where they remain until excretion. If the passage is now interrupted at one point, the intestinal contents continue to accumulate and massive pain can result. Anything that could block the bowel can be considered as a cause.
For example, an intestinal obstruction can be the cause. In addition, scarring can occur after an operation, which hinders intestinal peristalsis and passage. Also conceivable are congenital malformations of the intestine, so that it cannot fulfil its function properly.
An example of a congenital malformation is atresia of the intestine. An atresia is the closure or absence of hollow organs, such as the intestine. Congenital stenoses, constrictions, are also causes of intestinal obstruction.
Also important is the so-called volvulus, a twisting of the intestine, in which an intestinal loop winds around itself and thus interrupts the passage of faeces. The most important and most frequent cause, however, is a completely different one, namely the invagination of the small intestine. The small intestine is invaginated in such a way that its position and peristalsis puts pressure on the appendix and the ascending colon.
Another important cause is a meconium ileus. The meconium is the baby’s first excretion. It is not a stool, but a mass of thickened bile, amniotic fluid and swallowed hair and skin cells that accumulates naturally in the intestine during pregnancy.
This mass is excreted after birth, and is replaced by stool when the baby eats. If the meconium is not excreted, this indicates an intestinal obstruction in the baby. Intestinal obstruction in newborns is a symptom that also occurs in connection with cystic fibrosis and Hirschsprung’s disease.
It can therefore be seen that the causes are very broad, but the result is more or less the same: a pathological change in the intestinal passage. – swallowed foreign bodies (possibly small toys)
- Tumours
- Gallstones or also
- Entangled intestinal loops
A distinction is made between two types of intestinal obstruction: Mechanical intestinal obstruction is the form of intestinal obstruction in which intestinal passage is obstructed by obstacles. These can be tumours, gallstones, foreign bodies or chronic diseases such as Crohn’s disease.
The functional ileus is an intestinal obstruction caused by impaired peristalsis. This leads to cramping or paralysis of the intestinal muscles (so-called paralytic ileus), which can be accompanied by peritonitis. However, this is rather rare in newborns and therefore not a typical type of intestinal obstruction in babies.
- More functional and
- Mechanical ileus
Now how is it determined that the baby is suffering from an intestinal obstruction? First of all, a doctor should be consulted if the symptoms are noticeable, as described above. This doctor will palpate the baby’s abdomen for pain and hardening.
Then an ultrasound examination is performed. This often reveals characteristic pendulum movements of the intestinal contents. The stool swings back and forth in the intestine.
In addition, one can see air- or liquid-filled distended sections of intestine. A so-called “hunger bowel” is also often seen, i.e. behind the closure empty bowel sections are often collapsed (collapsed) because they are empty. In addition, an X-ray is taken to take a closer look at the intestine.
The doctor also has the possibility to listen to the abdomen and the intestinal sounds. In the case of a mechanical ileus, he hears a so-called “hyperperistalsis”, i.e. increased intestinal movement. In a functional ileus with loss of intestinal peristalsis, however, there is dead silence.
If necessary, a contrast medium can also be administered to narrow down the location of the obstruction more precisely. Finally, the CT scan is used for diagnostic purposes. The therapy of intestinal obstruction in babies depends on the cause.
In the case of an intussusception, an enema with saline solution or a contrast enema is used to move the intestine back into the correct position. A meconium-induced intestinal obstruction in babies is also treated in this way, with the intention of flushing out the meconium congestion. However, surgery is often necessary if these measures do not help.
In severe cases, when the intestine is already severely damaged, the affected piece must be surgically removed. Fortunately, this is rarely necessary. During the operation, the abdominal wall is opened up, thus allowing access to the intestine.
The surgeon can then surgically move the intestine back into the correct position. Surgery is usually unavoidable, for example in the case of congenital malformations. After the operation, the children first remain in the intensive care unit and are observed.
They are not allowed to eat independently at first and are fed parenterally. This means that they are fed by an infusion to relieve the intestines. There is also the possibility of feeding through a stomach tube.
This ensures that the intestine is relieved for a sufficiently long time to allow it to heal properly. In case of inflammation or infectious disease of the intestine, additional medication is administered. In severe cases, when the intestine is already severely damaged, the affected part must be removed surgically.
Fortunately, this is rarely necessary. During the operation, the abdominal wall is opened and thus access to the intestine is made possible. The surgeon can then surgically move the intestine back into the correct position.
Surgery is usually unavoidable, for example in the case of congenital malformations. After the operation, the children first remain in the intensive care unit and are observed. They are not allowed to eat independently at first and are fed parenterally.
This means that they are fed by an infusion to relieve the intestines. There is also the possibility of feeding through a stomach tube. This ensures that the intestine is relieved for a sufficiently long time to allow it to heal properly. In case of inflammation or infectious disease of the intestine, additional medication is administered.
