Intussusception in Infancy and Childhood in Southern Africa: A Review of 223 Cases

Abstract

Mayell, M. J. (1972). Archives of Disease in Childhood, 47, 20. Intussusception in infancy and childhood in Southern Africa. A review of 223 cases. Two hundred and twenty-three cases of intussusception admitted over a 9a-year period are analysed. Six deaths occurred.Sigmoidorectal intussusception occurred on 5 occasions and in each case was referred as a case of rectal prolapse, and the diagnosis and management of this particular form of intussusception are discussed.Intussusception is a common cause of intestinal obstruction in infancy and childhood and its occurrence is world wide. That there are geographical variations in its incidence is well known, but a review of the cases admitted to the Children's Hospital in Cape Town has shown certain other differences not previously reported. It is the purpose of this paper to present the Cape Town experience with intussusception and to draw attention to and comment upon these apparent continental and racial variations in the disease pattern.The data presented are drawn from a review of 223 children admitted with intussusception to hospital during a 91-year period ending in May 1970. The hospital is multiracial and admits children of all ages up to and including 12 years.The mean annual admission rate for the review period was 23 5 but the variation from year to year was quite marked (Fig. 1) have been termed idiopathic in the absence of any obvious local lesion though in many cases more general predisposing factors were present; their significance is discussed later.The age range was from 1 month to 11 years, the peak incidence being between 4 and 8 months (Fig. 2). Idiopathic intussusception was more common in infants under 1 year (129/206 or 63%), whereas 14 of the 17 cases with leadpoint pathology were over the age of 1 year. Separate consideration of the 3 main racial groups showed that most of the European children were under 1 year (36/41), two-thirds of the African

A comparison of manual versus hydrostatic reduction in children with intussusception: Single-center experience

“…In previous studies of respiratory and gastrointestinal infections, peaks occurred in the summer and winter months. [6] However, in the current study, there was no difference in the frequency of intussusception between seasons. In previous studies, the ileocolic region has been reported to be the area most affected [7] and in the current study, ileocolic intussusception was determined in 88.9% of patients according to the evaluation of the USG results.…”

Retrospective Surveillance of Intussusception in South Africa, 1998–2003

“…This phenomenon has been reported elsewhere, where natural infection with wild-type human rotaviruses has not been associated with intussusception [8,19,21]. Previous reports of intussusception in South African infants highlight the frequent delay in presentation, as well as differences in the age at presentation and a higher incidence of colocolic intussusception in older black patients [22][23][24][25]. The aim of this study was to document the prevalence of intussusception in South Africa in 1998-2003, thus providing important background information with which to interpret rotavirus vaccine postmarketing surveillance as the vaccine is introduced in South Africa in 2009.…”

Factors determining clinical outcomes in intussusception in the developing world: Experience from Johannesburg, South Africa

“…Mayell [7] reported a 22.7% resection rate, with the rest of the operative cases undergoing spontaneous or manual reduction, possibly demonstrating poor selection for operation in their series. There has been a steady decrease in the number of manual reductions over the years, with our experience demonstrating the lowest manual reduction rate in SA, [611] suggesting that institutional protocols for PR are stringent and reliable.…”