Intestinal Obstructions Health Article

When to call the doctor

Medical attention is needed early in intestinal obstruction and should be sought as soon as symptoms suggest abdominal distress. Symptoms may begin with abdominal pain or cramping that may cause a toddler or older child to double over in pain. Infants will periodically cry in pain and pull their legs up to their chest. Fever may or may not be present. Vomiting may occur along with pain. If pain and crying occur every 15 or 30 minutes, it is critical to see the pediatrician or go to the emergency room so that early diagnosis can be made and treatment begun.

Diagnosis

If the doctor suspects intestinal obstruction based on the child's symptoms and the physical examination, imaging studies will be ordered that may include abdominal x rays, computed tomography (CT scan), or an ultrasound evaluation of the abdomen. Abdominal ultrasound is able to effectively visualize and diagnose most obstructions. The x ray images may be enhanced by giving the child a barium enema, a form of contrast or opaque media that allows more detail to be seen in x rays and MRI or CT scans. In a barium enema, barium sulfate is infused through the rectum and the intestinal area is scanned. With contrast enhancement, the exact location of the obstruction can be pinpointed in the scans or x ray film. Sometimes a lighted, flexible fiber optic instrument (sigmoidoscope) may be inserted rectally in conjunction with a barium enema to visualize the bowel. It may not possible to determine if an obstruction is simple or strangulated on scanning, and this will only be determined by performing abdominal surgery.

Diagnostic testing will include a complete blood count (CBC), electrolytes (sodium, potassium, chloride) and other blood chemistries, blood urea nitrogen (BUN), and urinalysis. Coagulation tests may be performed if the child requires surgery.