Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Intussusception is an emergency and requires immediate attention
Who is at greatest risk for intussusception?
Most cases of intussusception occur in children between 5 months and 1 year
of age. Boys develop the condition two times more often than girls.
Intussusception can also occur in adults and older children, although it is
uncommon.
What causes intussusception?
The causes of intussusception are not fully known. Most cases in young
children are idiopathic, (meaning the cause is unknown), although some
viral and
bacterial infections of the intestine may possibly contribute to intussusception
in infancy.
Intussusception is very rare in older children and adults. In this
population, the causes are believed to be due to
polyps or tumors, which are
often referred to as the "lead point" of the intussusception.
Why is rapid diagnosis of intussusception important?
Early diagnosis and treatment of intussusception is
essential in order to prevent injury to the intestine and the associated sequelae, including
surgical removal of the bowel, sepsis, and even death.
The primary symptom of intussusception is described as
intermittent crampy abdominal pain. This is often called "colicky pain." Intussusception in an
infant usually starts with
the infant suddenly crying very loudly, as if in great pain. The infant
intermittently draws the knees up to the chest while crying. This reaction is
caused by the abdominal pain which recurs frequently and increases in intensity
and duration. These intermittent painful episodes are believed to be caused by
the telescoping of the bowel and resultant compression of blood vessels and
nerves.
In addition to the abdominal pain, most children will also have episodes of
vomiting associated with the pain. This vomiting is usually not associated with
eating and may be bilious (yellow-green colored)
Some affected individuals who do not seek early medical attention may pass
"currant jelly stool". This is stool that is bloody and mucousy and may be a
sign that the affected bowel has lost its blood supply and that the bowel may be
necrotic (non-viable).
As the condition progresses, the infant becomes may become weaker and develop
additional symptoms, including those associated with shock, such as paleness,
lethargy, and even
fever, though these are not an integral part of the
associated "triad."
Thankfully, most cases are diagnosed early, and some studies describe the
development of the bloody stools as occurring in only one-third of the cases
diagnosed.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Colic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.
Cystic fibrosis is a disease of the mucus and sweat glands. Cystic fibrosis is an inherited disease. The outcome of the disease leaves the body malnourished, bulky and fouls smelling stools, vitamin insufficiency, gas, painful or swollen abdomen, infertility, susceptible to heat emergencies, and respiratory failure. There is no cure for cystic fibrosis, treatment of symptoms is used to manage the disease.
Rotavirus is the most common cause of severe diarrhea among infants and children throughout the world. Almost all children have become infected with rotavirus by their third birthday. Repeat infections with different viral strains are possible, and most children have several episodes of rotavirus infection in the first years of life. Children between the ages of six and 24 months are at greatest risk for developing severe disease from rotavirus infection. Rotavirus symptoms include: fever, vomiting, watery diarrhea, and abdominal pain. Rotavirus infection can be associated with severe dehydration in infants and children.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
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