Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria

Tagbo, Beckie Nnenna; Mwenda, Jason M.; Eke, Christopher Bismarck; Oguonu, Tagbo; Ekemze, Sebastin; Ezomike, Uchechukwu Obiora; Edelu, Benedict O; Amadi, Ogechukwu F; Okeke, Ifeyinwa B; Ani, Okechukwu; Nnani, Roservelt Okechukwu; Okafor, Vina; Okafor, HU; Obidike, Egbuna; Abanida, Emmanuel; Elemuwa, Chris; Odetunde, Toyin

doi:10.4236/wjv.2014.43015

Cited by 5 publications

(18 citation statements)

References 27 publications

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“…This argument is underscored in this series where the median durationof presentation was 3 days, with gangrenous bowel noted in 62.1% of the cases. The mortality rate of cases with intussusception in this series at 10%, is similar to the reported mortality rate of 5-28% in series form developing countries [ 8 , 10 – 12 ].…”

Section: Discussionsupporting

confidence: 88%

“…In this study, intussusception was the most common cause of IO in infants. Similar to other studies from developing countries, most of the cases of intussusception in this series were managed surgically [ 1 , 2 , 5 , 8 – 12 ]. The predominant operative management is due to delayed patient presentation with concern for gangrenous bowel, predominant clinical diagnosis, with a significant proportion of cases being confirmed at laparotomy and lack of around-the-clock radiologic facilities and personnel to perform nonsurgical reduction [ 2 , 11 , 12 ].…”

Section: Discussionsupporting

confidence: 79%

“…Similar findings were noted in this series, with the slightly higher proportions due to the lower number of cases. Intussusception has been reported to be not only the most common cause of IO in infants [ 8 , 9 ], but also the most common cause of IO in children overall, responsible for 22-46% of all cases of IO [ 1 , 2 , 4 , 5 ]. In this study, intussusception was the most common cause of IO in infants.…”

Section: Discussionmentioning

confidence: 99%

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The spectrum of paediatric intestinal obstruction in Kenya

Ooko¹,

Wambua²,

Oloo³

et al. 2016

Pan Afr Med J

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IntroductionIntestinal obstruction (IO) occurs when there is impedance to the flow of intestinal contents due to a congenital or acquired pathology, and is a common paediatric surgical emergency. This study aimed to assess the pattern and outcome of paediatric IO in western Kenya.MethodsA retrospective review of all recorded cases of mechanical IO in patients aged 15 years or below admitted at Tenwek Hospital between January 2009 and December 2013.ResultsThe cohort included a total of 217 children (130 boys and 87 girls). The mean age was 6.7 years (range: newborn-15 years), with most (65, 30%) cases aged 1-3 years. Vomiting (161, 74.2%), abdominal pain (152, 70%), abdominal tenderness (113, 52.1%), constipation (111, 51.2%), and abdominal distension (104, 47.9%) were the predominant signs and symptoms. The most common causes of IO were ascariasis (96, 44.2%), adhesions (34, 15.7%), and intussusception (30, 13.8%). Intussusception was the leading cause of IO in children aged ≤ 1 year, ascariasis in children aged 1-5 and 6-10 years, and adhesions in children aged 11-15 years. Operative management was undertaken in 120 (55.3%) cases with 39 (32.5%) of these having gangrenous bowel. The overall mortality rate was 5%.ConclusionThe most common causes of mechanical bowel obstruction in this series were ascariasis, adhesions, and intussusception. Ascariasis remains a significant cause of paediatric IO in this region, thus public education, improved sanitation and deworming campaigns may be helpful in reducing the worm burden.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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The spectrum of paediatric intestinal obstruction in Kenya

Ooko¹,

Wambua²,

Oloo³

et al. 2016

Pan Afr Med J

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“…There were significant variations in the clinical features among the children across the regions, which may be due to the interval for presentation or clinical practices followed at the hospitals (Table 2 ). Death was observed in 1.7% cases, which was comparable to reports from India (1.0%) and other countries from Asia (0.25–6.0%), Latin America (1.0–5.0%), but lower than the African countries (2.0–25.0%) [ 17 , 18 , 24 , 28 , 29 , 31 – 33 ]. Level 1 BCCD was met by 89.1% of the cases, similar to other reports from India [ 5 , 7 , 14 ].…”

Section: Discussionsupporting

confidence: 74%

Prospective surveillance for intussusception in Indian children aged under two years at nineteen tertiary care hospitals

Das¹,

Arora²,

Gupta³

et al. 2020

BMC Pediatr

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Background: India introduced rotavirus vaccines (RVV, monovalent, Rotavac™ and pentavalent, Rotasiil™) in April 2016 with 6, 10 and 14 weeks schedule and expanded countrywide in phases. We describe the epidemiology of intussusception among children aged 2-23 months in India. Methods: The prospective surveillance at 19 nationally representative sentinel hospitals from four regions recruited children with intussusception from April 2016 to September 2017. Data on sociodemography, immunization, clinical, treatment and outcome were collected. Along with descriptive analysis, key parameters between four regions were compared using Chi-Square/Fisher's exact/Mann-Whitney U/Kruskal-Wallis tests. The pre-and post-RVV periods were compared to estimate the risk ratios. Results: Six hundred twenty-one children with intussusception from South (n = 262), East (n = 190), North (n = 136) and West (n = 33) regions were recruited. Majority (n = 465, 74.8%) were infants (40.0% aged 4-7 months) with median age 8 months (IQR 5, 13 months), predominantly males (n = 408, 65.7%) and half (n = 311, 50.0%) occurred during March-June months. A shorter interval between weaning and intussusception was observed for ragi based food (median 1 month, IQR 0-4.2 months) compared to rice (median 4 months, IQR 1-9 months) and wheat (median 3 months, IQR 1-7 months) based food (p < 0.01). Abdominal pain or excessive crying (82.8%), vomiting (72.6%), and bloody stool (58.1%) were the leading symptoms. Classical triad (abdominal pain, vomiting and bloody stool) was observed in 34.8% cases (24.4 to 45.8% across regions). 95.3% of the cases were diagnosed by ultrasound. 49.3% (10.5 to 82.4% across regions) cases were managed by reduction, 39.5% (11.5 to 71.1% across regions) cases underwent surgery and 11.1% spontaneously resolved. Eleven (1.8%) cases died. 89.1% cases met Brighton criteria level 1 and 7.6% met Level 2. RVV was received by 12 cases within 1-21 days prior to intussusception. No increase in case load (RR = 0.44; 95% CI 0.22-1.18) or case ratio (RR = 0.5; 95% CI 0.3-1.2) was observed after RVV introduction in select sites. Conclusions: Intussusception cases were observed across all sites, although there were variations in cases, presentation and mode of management. The high case load age coincided with age of the RVV third dose. The association with ragi based weaning food in intussusception needs further evaluation.

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“…In this group of children, there may be hypertrophy of the mural lymphoid tissues, known as Peyer's patches, in the terminal ileum as a result of a viral illness (caused by adenovirus or rotavirus), with a history of acute gastroenteritis and/or respiratory tract symptoms. 5 The clinical features of intussuception includes inconsolable cry of sudden onset, abdominal distension, vomiting, and passage of bloody mucoid stool. At presentation they are usually dehydrated, weak, anemic with distended abdomen.…”

Section: Introductionmentioning

confidence: 99%

Outcome of intussusception among children in Kano

et al. 2021

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Intussusception is defined as the telescoping of a segment of the gastrointestinal tract within the lumen of the adjacent segment usually proximal to distal. It is a common cause of intestinal obstruction in children, rarely it can occur in adult. This condition is reported in both developed and developing countries, however there are few publications in Nigeria about the incidence, presentation and outcome of its management, most especially in children. This is a prospective study of pediatric patients managed in single center Kano over a period of 18months. The demographic data, clinical features, treatment and outcome of the management were evaluated and analyzed using SPSS version 23. Between June 2018 to December 2019, twenty-five children were managed with intussuception at Aminu Kano Teaching Hospital, there were 16 males and 9 females. The age of the patients ranges between 5 months to 6 years with most of patients in the ager range between 6 and 12 months. All of the 25 patients had exploratory laparotomy with manual reduction in 12 patients, while 13 patients had resection and anastomosis. Non-operative reduction using normal saline under ultrasound guidance was attempted for 2 patients, which was not successful. The length of hospital stay ranged between 4 days and 22 days. Few complications were observed which includes surgical site infection, wound dehiscence, postoperative ileus. One patient was re-operated for recurrent intussuception. Two patients died post operatively, while 23 patients were discharged home alive. Intussuception is still a common cause of intestinal obstruction in children in Kano. Late presentation was found to be associated with higher morbidity (complications).

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Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria

Cited by 5 publications

References 27 publications

The spectrum of paediatric intestinal obstruction in Kenya

The spectrum of paediatric intestinal obstruction in Kenya

Prospective surveillance for intussusception in Indian children aged under two years at nineteen tertiary care hospitals

Outcome of intussusception among children in Kano

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