Chronic intussusception in children

Abstract

Nine children presented with intussusception lasting for 14 days or more. Their mean age was 8.5 years. Diagnosis of intussusception was delayed considerably, probably due to an unusual presentation. Compared with acute intussusception, symptoms consist of infrequent attacks of abdominal pain, sporadic vomiting and no, or small, changes in defecation. Marked weight loss and an abdominal mass assume diagnostic significance, in contradiction to bloody stools. Ultrasonography can be of diagnostic value. An attempt at hydrostatic reduction is often unsuccessful. A high frequency of organic lesions precipitating intussusception warrants early surgical intervention.

Chronic Intussusception

“…2,8 A striking feature of CI is emaciation and a marked loss of weight, which could be attributed to prolonged anorexia and vomiting. In the absence of a palpable abdominal mass and the presence of diarrhea, some reported cases have been misdiagnosed and investigated thoroughly for malabsorption.…”

“…While it has a successful hydrostatic reduction rate ranging between 19% and 85% in acute cases, 6 a barium enema in CI has not been effective therapeutically. 8,10 Due to the high rate of unsuccessful hydrostatic reductions, all cases of CI should be treated surgically, as there is a high incidence of specific pathology which needs surgical intervention. Moreover, some authors recommend other procedures, such as appendectomy or ileopexy, in addition to the manual reduction of the intussusception, in order to prevent recurrence.…”

Chronic intussusception in children caused by Ascaris lumbricoides

“…Sometimes it is related to non-Hodgkin lymphoma, Yersinia enterocolitica mesenteric adenitis, Ewing sarcoma, intestinal lymphoid hyperplasia or parasitic infection [1,[6][7][8][9]. Th e incidence is estimated to be about 5% of all intussusceptions, fewer in young children than in preschool age [1,5,6].…”

“…Chronic intussusception (CI) is a rare cause of recurrent abdominal pain [5]. It should be taken into account when the child presents with a clinical picture lasting for more than 14 days.…”

“…Th e symptoms are usually less severe than in the AI. Recurrent abdominal pain, palpable abdominal mass, vomiting, rectal bleeding, diarrhea, loss of appetite, nausea, weight loss and microcytic anemia are most common signs of CI [3,5]. Sometimes it is related to non-Hodgkin lymphoma, Yersinia enterocolitica mesenteric adenitis, Ewing sarcoma, intestinal lymphoid hyperplasia or parasitic infection [1,[6][7][8][9].…”