Addressing Challenges in the Management of Paediatric Intussusceptions in the District Hospital

Abstract

Intussusception is the leading cause of intestinal obstruction in children and its management can be challenging especially in centres with inadequate resources where this problem becomes more daunting. Nineteen cases of intussusception in the paediatric age group which were managed by medical officers in a district Hospital in Ghana are discussed. The outcomes of cases treated by open surgery, and those managed by pneumatic reduction were studied. We highlight the use of an improvised set up used in achieving pneumatic reduction thereby obviating operative reduction.

Pattern, presentation, and management of intussusception at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria

“…Male preponderance has consistently been reported in the literature. [1,3,8] Eleven patients (50%) were <12 months of age with a peak at 7-8 months, findings are similar to those reported by Tagbo et al [3] who reported 88.3% of cases in infants. Patients with intussusception typically present with a triad of vomiting, abdominal pain, and bloody mucoid stool.…”

“…All patients had laparotomy, with ileocolic intussusception being the most common type seen, consistent with previous reports. [4,13] Ten patients (45%) had a manual reduction, while 12 (55%) patients had an intestinal resection, similar to rates reported by Gudugbe et al [1] In a review by Bode, [4] 27.8% of patients who had laparotomy had a bowel resection and anastomosis while Taiwo et al, [12] on the other hand, reported a resection rate of 43.6%; while Tagbo et al [3] reported 31.7%. This is attributable to the delayed presentation and late diagnosis in the hospital, resulting in perforation, and gangrene.…”

“…[14] Post-operative complications encountered included surgical site infection, anemia, sepsis, and incisional hernia, not different from those previously reported in the literature. [4,11] The mortality rate in this study was 32%, well below 63.7% reported by Gudugbe et al, [1] but higher than 5% reported by Tagbo et al, [3] or 16.2% by Madziga and Nuhu. [13] These values are all in contrast to the >1% mortality estimated for developed countries.…”

“…Intussusception is the telescoping of a proximal segment of the bowel into an adjourning intestinal lumen. [1] It is the most common cause of intestinal obstruction in infants, usually occurring between 4 and 10 months, [2] with an estimated incidence of 0.5-4.3 cases per 1000 live births in developed countries. [3] It classically presents with a triad of vomiting, colicky abdominal pain, and bloody mucoid diarrhea.…”

Colocolic intussusception as a rare cause of intestinal obstruction in a preschool child: A case report

“…Intussusception is the invagination of a segment of the intestine into the distal segment [ 1 ]. It is a common abdominal emergency in children younger than 5 years presenting with features of intestinal obstruction [ 2 ].…”