Intussusception: Trends in clinical presentation and management

Abstract

Over the past 40 years at Royal Children's Hospital, Melbourne the hospitalization rate due to primary idiopathic intussusception has marginally increased from 0.19 to 0.27 per 1000 live births. Diagnosis and treatment using air enema has been highly successful, resulting in a reduction in patients requiring surgery and reduced hospital stays.

Paediatric emergencies

“…The classic triad of emesis, pain and bloody stools may only be present in up to 45% of cases [55,56]. An abdominal mass may be present and the diagnosis, if suspected, can be confirmed by air enema.…”

“…This technique has a success rate as high as 82% [56]. Whilst urgent treatment of intussusception is the priority, it is important that hypovolaemia is recognised and anticipated.…”

“…Sedative drugs and general anaesthesia are not usually necessary, but the anaesthetist should carefully monitor the cardiorespiratory and fluid status and take measures to prevent and treat hypothermia. Failed air enema is not uncommon and a repeat air enema may be effective [56]. If air enema does not reduce the intussusception, laparotomy performed by a paediatric surgeon is indicated.…”

Neonatal Intussusception: A Review

“…Intussusceptions occur at the rate of 1-4 in 2000 infants and children [6,7]. Although seen in all pediatric age groups and even in adults, it is most commonly seen in first two years of life (75%).…”

“…More than 40% present between 3-9 months of age. Male to female ratio is 2:1 to 3:2 [6,8].Since neonatal intussusception is an uncommon entity, we conducted this review to examine its occurrence, clinical features, pathophysiology, and management.…”