Intussusception Among Young Children in Europe

Abstract

Intussusception, a potentially lethal condition with poorly understood etiology, is the most common cause of acute intestinal obstruction in children younger than 5 years old. In some cases, the condition has been associated with administration of the first licensed rotavirus vaccine, the reassortant rhesus-human tetravalent rotavirus vaccine (RRV-TV; RotaShield). No such association has to date been reported from large phase III safety trials with new rotavirus vaccines. As 2 new, live-attenuated oral rotavirus vaccines are currently under review for approval by the European Union regulatory authorities, a review of the clinical, etiologic and epidemiologic aspects of intussusception in Europe is urgently needed. We conducted a review of Medline literature, published from 1995 onwards on intussusception in the World Health Organization's European Region. The results are compared with data from previous reviews and other regions. The classic triad of intussusception symptoms (abdominal pain, abdominal mass, bloody stools) was present in 29-33% of patients according to the medical literature reviewed. Conservative treatment (barium, air or saline enema) was the rule (81% of cases), and few complications were observed during treatment. Treatment outcome was generally favorable, with recurrence occurring in approximately 1 in 10 patients, and only 1 death reported. Structural lead points were seen in 3% of patients; no other reliable data on the etiology of intussusception were found. The incidence of acute intussusception in young children in Europe, according to 6 heterogeneous hospital-based studies, ranged from 0.66 to 2.24 per 1000 children in inpatient departments and from 0.75 to 1.00 per 1000 children in emergency departments. Peak incidences were found in children 3-9 months of age. There are still gaps in our knowledge of intussusception with respect to its etiology and especially by which mechanisms RRV-TV might have caused it to occur. Data from regions outside Europe showed that rotavirus infection and disease are not associated with intussusception. As new rotavirus vaccines become available for use in Europe, postlicensure surveillance for intussusception is indicated and may be instrumental in further understanding the epidemiology of this condition and in further assessing the safety of future vaccines.

Ultrasound guided hydrostatic reduction of intussusception in children by saline enema: our experience

“…Intussusception is a common cause of acute intestinal obstruction in infants; it is also seen in older children and adults occasionally [1]. Intussusception accounted for 16% of all cases of intestinal obstruction in children in one study from India [2] For reasons that are unclear, intussusception is relatively uncommon in Asia and Africa despite the high incidence of infective diarrheal diseases in children found in these regions [1,2].…”

“…Intussusception accounted for 16% of all cases of intestinal obstruction in children in one study from India [2] For reasons that are unclear, intussusception is relatively uncommon in Asia and Africa despite the high incidence of infective diarrheal diseases in children found in these regions [1,2]. Intussusception is managed by an initial attempt at non-operative reduction with either barium enema or saline water enema or air-insuffl ation through rectum; failure of multiple attempts or signs of peritonitis are indications for operation.…”

Intussusception in adults – a study of four cases

“…Wgłobienie jest najczęstszą przyczyną niedrożności u dzieci poniżej 5. roku życia, zwłaszcza noworodków [5]. Wyjątkowo rzadko występuje u ludzi dorosłych.…”

Pattern of Intussusception on Infants and Children in Dr. Hasan Sadikin Hospital Bandung

“…[1][2][3][4] If not treated immediately, intussusceptions can be potentially lethal; because it can obstruct arterial blood supply to the intestines, and cause necrosis and perforation of the intestines. 2,3 The incidence of acute intussusceptions on infants and children is reported varying; between 1.5 to 4 cases for every 1000 live births. 1,5 Data on the acute intussusceptions incidence on infants and children in developing countries are still very few.…”

“…[1][2][3] This condition is the most common cause for acute intestinal obstruction in infants and children. [1][2][3][4] If not treated immediately, intussusceptions can be potentially lethal; because it can obstruct arterial blood supply to the intestines, and cause necrosis and perforation of the intestines. 2,3 The incidence of acute intussusceptions on infants and children is reported varying; between 1.5 to 4 cases for every 1000 live births.…”