Diamond M., 1

Diamond is a 6-month-old baby and the only child in his family. Both of his parents are young; his father works as a farmer, and his mother is currently unemployed. The family lives together in a rented one-room apartment. Recently, Diamond was brought to the facility due to an intestinal obstruction caused by intussusception. He has been admitted to the General Hospital for the past five days. However, due to financial constraints, the necessary surgery has not been performed yet.

At surgery, there was invagination of the caecum appendix and terminal ileum into the ascending colon. About 1/3 portion of the ileum, caecum and appendix were gangrenous. The gangrenous portion was excised and ileocolic anastomosis was carried out. The patient was transfused with one pint of blood intraoperatively. Repair and close done in layers with unstable vital signs. The PCV on admission was 25% with varied WBC (20,000). He was immediately commenced on Rocephine 500mg start, then 250mg 12hly, IV Genticine 20mg 12hly and rehydrated. He was taken to the theatre after resuscitation. At surgery, there was invagination of the caecum appendix and terminal ileum into the ascending colon. About 1/3 portion of the ileum, caecum and appendix were gangrenous. The gangrenous portion was excised and ileocolic anastomosis was carried out. The patient was transfused with one pint of blood intraoperatively. Repair and close done in layers with unstable vital signs.

The telescoped segment of the intestine can lose its blood supply, causing tissue death. This necrotic tissue can lead to perforation and infection. Surgery is necessary if non-surgical methods fail, if there are signs of bowel perforation, necrosis, or if the patient is too ill for non-surgical reduction. The surgeon makes an incision in the abdomen and manually unfolds the telescoped section of the intestine. If any part of the intestine is necrotic, the surgeon will remove the damaged section and sew the healthy ends back together (anastomosis).