Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms

Abstract

Objectives Intussusception is one of the most common surgical emergencies in children. We aimed to analyze the current clinical characteristics of intussusception. Methods We retrospectively reviewed 209 children diagnosed with intussusception, who were admitted to our hospital between January 2009 and August 2022. We grouped the patients according to symptom duration (before and after 12 hours and before and after 24 hours) and age (younger and older than 1 year, and younger and older than 2 years). Results The median age at admission was 31 months (2–204 months). The median symptom duration was 12 hours (1–420 hours). Most patients (91.4%) were admitted due to abdominal pain, irritability, and/or vomiting. The most common symptoms were vomiting (70.8%) and abdominal pain (60.6%). The classical triad of symptoms was seen in 9 cases (4.3%). In patients aged younger than 1 year, bloody stool, abnormal abdominal radiography findings, and a longer intussusceptum segment were more frequent. In patients aged younger than 2 years, abdominal pain, fever, and defense on physical examination were less frequent, and irritability, bloody stool, and recurrence were more frequent. Patients aged younger than 2 years had a longer intussusceptum segment and less lymphadenopathy based on ultrasonography (USG). The patients admitted more than 12 hours after symptom onset had more diarrhea, fever, abnormal x-ray, peritoneal fluid on USG, and recurrences, and less vomiting. After the symptoms had lasted for 24 hours, fever, mass palpation, and abnormal abdominal radiography findings were more frequent. Conclusions We recommend performing abdominal USG, especially in young children admitted to the emergency department with complaints of abdominal pain and/or vomiting, to rule out intussusception. In countries that have reported a high mortality rate from intussusception, we advise precautions such as increasing the availability of USG in emergency departments and educating the population to seek early medical assistance.

Epidemiological characteristics, treatment, and outcomes of 586 cases of intussusception: a 4-year retrospective study in China

“…However, it only accounted for 5.3% (31/586) in this study, with the most common symptoms being abdominal pain (or paroxysmal crying) (95.73%), vomiting (45.39%), and bloody stool (7.34%). This finding differed from the data reported in other studies, which we hypothesized might be due to the age composition of our study cohort ( 16 ). Our analysis revealed that patients' symptoms of intussusception became atypical with increasing age as the occurrence rates of vomiting and bloody stool significantly decreased ( P < 0.001) ( Table 3 ).…”

Gastrointestinal bleeding in children: diagnostic approach

“…In patients aged younger than 1 year, “currant jelly” bloody stool, abnormal abdominal radiography findings, and a longer intussusceptum segment are more frequent [ 16 , 28 , 30 ].…”