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Smal Bowel Intussusception that was Needed Explorative Laparotomy because of Hypovolemic Shock
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ÀåÀÍ¿Ï ( Chang Ik-Wan )
¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
±èµµ±Õ ( Kim Do-Kyun )
¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
ÃÖÀ翬 ( Choi Jea-Yeon )
¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
¼µ¿¹ü ( Suh Dong-Bum )
¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
Á¤ÀçÀ± ( Jung Jae-Yun )
¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
°û¿µÈ£ ( Kwak Young-Ho )
¼¿ï´ëÇб³ ÀÇ°ú´ëÇÐ ÀÀ±ÞÀÇÇб³½Ç
KMID : 1037620140010010053
Abstract
Intussusception is the most common cause of gastrointestinal obstruction in children, which occurs most commonly in children aged between 3 and 12 months. Small bowel intussusception is uncommon in children compared to adults, and is not reduced by air reduction, unlike illeocecal intussusception. During the post-enema reduction period, patients could experience a delayed complication of hypovolemic shock. We report a case of small bowel intussusception that required explorative laparotomy due to hypovolemic shock. The patient was a 5 month-old female infant, who was diagnosed with small bowel intussusception and small bowel obstruction by sonography after a second air enema reduction. While observing her symptom, the patient¡¯s vital sign was becoming increasingly unstable. The patient received a large amount of fluid and inotropics. After a diagnostic computed tomography (CT) scan, the patient underwent explorative laparotomy to rule out bowel ischemia or necrosis. However, the patient¡¯s bowel was clear without minimal laceration on the surface of the bowel. After the operation, the patient recovered spontaneously. We suspect the patient¡¯s symptom and sign were caused by hypovolemia due to prolonged bowel ischemia and obstruction. Furthermore, resolving hypovolemic shock was caused by small bowel intussusception self-reduction. When pediatric physician is faced with small bowel intussusception in pediatric patients, they should provide adequate fluid supply and management along patient¡¯s state.
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Intussusception; Hypovolemia; Laparotomy
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