Clinical Characteristics According to Age and Duration of Symptoms to Be Considered for Rapid Diagnosis of Pediatric Intussusception

Abstract

Purpose: The purpose of this study was to evaluate whether clinical findings in children with ileocolic intussusception differ based on age and duration of symptoms and to assess the clinical characteristics of diagnosed and undiagnosed patients to determine which symptoms make diagnosis more difficult.Methods: We reviewed 536 medical records of <15-year-old children diagnosed with ileocolic intussusception between 2008 and 2019. We divided the children into three categories according to age (<1 year, 1–2 years, and ≥2 years). The children were also divided into two groups based on whether symptoms lasted for more or <6 h. Diagnosed and undiagnosed children were assessed separately during for the initial evaluation.Results: Following analysis of the three age groups, bloody stool, post-enema bloody stool, diarrhea, vomiting, poor oral intake, and lethargy were more frequent in children aged <1 year. In children aged ≥2 years, non-specific abdominal pain was more frequent and the undiagnosed rate was higher. Following analysis of the duration of symptoms, paroxysmal pain was significantly more frequent in the early group (<6 h), and bloody stool and fever were significantly more frequent in the late group (≥6 h). Nonspecific abdominal pain was more frequent and the door-to-diagnosis time was significantly longer in the undiagnosed group than in the diagnosed group.Conclusions: Clinical findings of ileocolic intussusception vary depending on the age and duration of symptoms. Younger children with paroxysmal pain, vomiting, bloody stool, poor oral intake, or lethargy should be suspected of having intussusception. In older children, non-specific abdominal pain without bloody stool may be a symptom of intussusception. Glycerin enema is helpful in diagnosing intussusception in children with no typical symptoms.

Clinical profile and treatment outcome of acute intussusception among children in eastern Ethiopia: A seven years retrospective study

“…The findings of this study indicated that the patients follow with acute intussusception was high between July and September, which is the rainy season with a second peak in December which is the dry season in Ethiopia. The present finding was similar to the findings reported in Asia ( 20 ), Africa ( 21 ), Jimma, Ethiopia ( 22 ), and Addis Ababa, Ethiopia ( 14 ). This might be explained by the higher occurrence of preceding respiratory infections and gastroenteritis in the pediatric population during the rainy and dry seasons.…”

Intussusception among Children Admitted in a Department of Pediatric Surgery of a Tertiary Care Centre: A Descriptive Cross-Sectional Study

“…9.3 %). 10 Though intussusception was first described by Paul Barbette in 1692, it took over 3 centuries before its sonographic features were described in 1977. Raffainsperger has written that as far back as Hippocrates' time, there were allusions to a reduction of intussusception by the injection of air/fluid into the rectum.…”

Intussusception in Older Children: A Single Center Experience

“…Atypical presentation of intussusception in older children may explain this delayed presentation. Park et al documented the changes in clinical characteristics of intussusception in children with intussusception [14]. Poverty and a low level of awareness on the part of the parents also influence the time of presentation to the hospital.…”

“…Abdominal pain was the most common presenting symptom in the patients. Other series on intussusception also published abdominal pain as the most common symptom of intussusception [14,15]. Khasawneh et al found vomiting as the most common symptom of pediatric intussusception [11].…”