Intussusception: A 14-year experience at a UK tertiary referral centre

Ondhia, Meraj; Al-Mutawa, Yousef K.; Harave, Srikrishna; Losty, Paul D.

doi:10.1016/j.jpedsurg.2019.07.022

Cited by 19 publications

(23 citation statements)

References 13 publications

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“…Bloody stool, though a key feature of intussusception, was less common than other symptoms. Its frequency varied considerably between studies, with reported rates ranging from 9 to 36% (16)(17)(18). In our study, only 23.1% (n = 124) of all patients had bloody stool, and it was more common in younger children (44.8, 18.2, and 6.9% in the <1, 1-2, and ≥2 year age groups, respectively, P < 0.001).…”

Section: Discussionmentioning

confidence: 44%

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

Park

Cho

2021

Front. Pediatr.

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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.

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Section: Discussionmentioning

confidence: 44%

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

Park

Cho

2021

Front. Pediatr.

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“…Unlike intussusception in children, the incidence of intussusception in adults is extremely low, and most of them are secondary [ 1 ]. In previous reports, adult intussusception occurred is mostly secondary to intestinal tumors, and other causes leading to adult intussusception are rarely reported in clinic settings.…”

Section: Introductionmentioning

confidence: 99%

A case of iatrogenic intussusception in adults: a rare case report

Sun

Shi

2021

BMC Surg

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Background Intussusception has a low incidence rate in adults. Many cases in adults are caused by tumors. Intussusception results from conditions other than tumors are uncommon. This is the first case report about intussusception that occurred after removing a long intestinal tube (LT). Case presentation A 69-year-old female complained of “recurrent abdominal pain with reduced flatus passage and frequency of bowel movement for 10 days” was admitted to the hospital. Plain abdominal radiography and abdominal CT upon admission showed intestinal obstruction. The patient’s abdominal pain was not relieved after symptomatic treatments, which involved fluid and electrolyte replacement, LT placement, spasmolytic agents, and analgesics. Hence, surgical exploration was carried out. The patient had a good recovery postoperatively. No abdominal pain or bloating developed after food intake. The patient passed flatus and had bowel movements later. On postoperative day 9, the LT was removed. On the 10th day, the patient suddenly developed abdominal distension and acute abdominal pain. Emergency abdominal CT showed small bowel intussusception. Surgical exploration was then performed. Severe small bowel dilatation located at 1.5 m from the ligament of Treitz was found during the procedure. Intussusception at the site was observed. No color change of the intestinal wall was detected, suggesting that no necrosis was present. So, a manual reduction was done. The patient was discharged on postoperative day 6. Conclusions This case serves as a warning that the simple action of pulling out the LT might also cause serious complications, which should be given more attention.

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“…In a 14-year study from a UK referral center, 44.48% patients were reduced successfully by non-operative treatment and 48% needed surgery. 14 However, air enema was used instead of liquid enema. Another study involving four hospitals in Hunan and Henan Provinces of China between 2009 and 2013 reported that among 1715 intussusception cases, air or Open access liquid enema reduction was performed in 80% cases; 16.3% required surgery without intestinal resection; and 2.6% required surgery with intestinal resection.…”

Section: Discussionmentioning

confidence: 99%

Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries

Chowdhury

Ahsan²,

Chowdhury

et al. 2021

World Jnl Ped Surgery

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BackgroundAlthough hydrostatic reduction of intussusception with ultrasound (US) or fluoroscopy guidance is well known, it is not yet well established in many low-income and middle-income countries. The aim of the study is to report our results of hydrostatic reduction with intermittent radiography, which has the potential to be practiced in resource-limited settings.MethodsWe retrospectively analyzed our patients with intussusception from 2009 to 2019 (11 years). Hydrostatic reduction was performed using water-soluble contrast medium (iopamidol), and reduction was followed with intermittent X-rays taken after every 50 mL of diluted contrast injection. The procedure was not continuously monitored by US or fluoroscopy. Differences in outcome based on age and gender, and yearly trends of admission for intussusception, types of treatment and mortality were analyzed.ResultsAmong 672 patients, the ratio of boys to girls was 2.46:1.0, and their ages ranged from 1 month to 15 years (median 8 months). Hydrostatic reduction was performed successfully in 351 (52.23%) patients; 308 (45.83%) patients underwent surgery; and 13 (1.93%) patients died before any intervention. There were significant differences in age between patients with successful hydrostatic reduction (median 7 months) and patients needing surgery (median 9 months) (p<0.001). The number of successful hydrostatic reductions increased during the 11 years of the study (R2=0.88). One patient (0.15%) died after hydrostatic reduction, and 10 (1.49%) died after surgery.ConclusionHydrostatic reduction with intermittent radiography was performed successfully in more than half of the patients with acceptable complication rates.

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Intussusception: A 14-year experience at a UK tertiary referral centre

Cited by 19 publications

References 13 publications

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

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

A case of iatrogenic intussusception in adults: a rare case report

Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries

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