What are the symptoms of abdominal distension in babies?

Everyone knows the feeling of abdominal bloating, as if your abdomen is like an inflated balloon with a lot of gas inside. If abdominal distension is severe, it may affect normal life and work, and the impact is greatest for people engaged in physical labor. In life, some children also have abdominal distension. So, what are the symptoms of abdominal distension in babies?

Clinical manifestations

Abdominal distension is a clinical symptom. Under normal circumstances, children over 2 years old are the same as adults, with no gas in the small intestine except the stomach and colon. The small intestine of newborns should be inflated with gas normally. The absence of gas accumulation is mostly a pathological phenomenon. Especially after a full meal, the entire abdomen swells, often higher than the xiphoid process, and the abdomen is empty when hungry. If it continues to swell and not deflate, and there is tension, it can be considered abdominal distension.

Most children have acute or chronic symptoms, with their abdomen bulging higher than the chest. Severe abdominal distension can affect breathing and make it impossible to lie flat.

Abdominal examination: When tapping the abdomen, tympanic sound indicates air, solid sound indicates a solid tumor, and solid sound accompanied by conductive tremor indicates effusion. Abdominal auscultation indicates hyperactive bowel sounds in case of mechanical intestinal obstruction, while bowel sounds are weakened or absent in case of paralytic intestinal obstruction.

There are also two types of bloating. Generally, it is gastrointestinal flatulence, but in a few cases it is pneumoperitoneum. In these two types of situations, in addition to abdominal upright X-ray examination to detect gas accumulation under the diaphragm, clinically, a light and shallow abdominal patting can feel that the pneumoperitoneum is relatively empty and soft, and the shape of the intestine can be felt when there is intestinal bloating. For older children, the diagnosis can be made by lying in the left lateral position and percussing the liver dullness boundary. The liver dullness boundary disappears when pneumoperitoneum occurs.

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Routine radiology examination

(1) Abdominal plain film: Since normal newborns and infants have physiological gas accumulation in the abdomen, whether the gas increases or decreases, it indicates the possibility of lesions. Therefore, the diagnostic value of abdominal plain film in children is much greater than that in adults. And the younger the age, the more information they can provide. In addition to indicating intestinal obstruction in different parts of the body, it may also indicate the size and location of abdominal space-occupying lesions. Abdominal plain films can also easily show the calcifications with different characteristics of meconium peritonitis and neuroblastoma and the skeletal shadows of teratoma, suggesting the diagnosis. Abdominal plain film should be the first choice for diagnosis of pneumoperitoneum.

(2) Gastrointestinal tract radiography ① Barium meal is very helpful in diagnosing congenital hypertrophic pyloric stenosis and duodenal obstruction. However, except for chronic incomplete intestinal obstruction, which can sometimes determine the location of the obstruction through barium meal, barium meal is generally not performed for low-level intestinal obstruction. Sometimes a barium swallow is done to determine the size and location of a space-occupying lesion in the abdomen. ② Barium enema is often required when colon lesions are suspected. For example, congenital megacolon can be diagnosed based on the spasm, transition and dilation of the child's colon, and intestinal atresia can be diagnosed based on the "fetal colon".

For children with intestinal obstruction, barium enema can be used to observe the presence of gas in the colon to determine whether the obstruction is complete. Pelvic masses and rectal lesions may also be diagnosed with a barium enema.

(3) Urinary tract angiography ① Intravenous pyelography (IVP) is often used to diagnose congenital malformations or tumors of the urinary system, such as hydronephrosis and Wilms' tumor. IVP can also indicate the secretory function of the kidneys. When other retroperitoneal masses are suspected, the diagnosis is often prompted by the discovery of compression and displacement of the kidneys or ureters through IVP examination. ② Retrograde cystography is most useful for diagnosing urethral valves, ureteral cysts and bladder tumors.