Treatment Outcome of Acute Intussusception in Children Under Two Years of Age: A Prospective Cohort Study

Abstract

Background Intussusception is a common cause of small intestinal obstruction in children under two years of age. Late diagnosis can lead to a potentially worse condition. This prospective study aims to describe the clinical manifestation and develop a conservative management protocol for acute ileocaecal intussusception in children under two years of age. Methods This prospective study was carried out in 118 consecutive patients under two years of age. Patients presented with symptoms and signs of acute intestinal obstruction and a diagnosis of ileocaecal intussusception confirmed by ultrasound were included in this study. All the patients were managed with either pneumatic reduction or operation. Results There were 70 boys and 48 girls ranging in age from three months to two years with a median of 12.5 months. Clinical presentation included abdominal pain (100%), vomiting (82.2%), bloody stool (11.9%), and a palpable mass (43.2%). Patients hospitalized with the symptoms and signs for less than 24 hours accounted for 80.5% of the cases. The overall success rate of pneumatic reduction was 98.3%. Late hospital admission (≥ 24 hours from illness onset), bloody stool, and presenting with the classic triad of symptoms of intussusception were found as the factors that correlated to the surgical management outcome. All patients recovered well without any complications. The median of postoperative hospital stay of two days for the pneumatic reduction group and six days for the operation group. Conclusion The early diagnosis of intussusception contributes to the success of pneumatic reduction and reduces the requirement of surgical intervention.

Clinical profile and treatment outcome of acute intussusception among children in eastern Ethiopia: A seven years retrospective study

“…This finding is comparable with the findings of Jimma University Medical Center ( 22 ), Tanzania ( 21 ) and systematic reviews in African countries ( 23 ). However, it was higher than the findings of studies from South Korea ( 24 ), Latin America ( 16 ), Vietnam ( 4 ), South Africa ( 7 ), Nigeria ( 25 ), and Bahrain ( 26 ). The possible reason for this discrepancy may be attributed to the huge variations in medical infrastructure accessible for the population and the quality of health care, coupled with the unavailability of recommended modern interventions for the management of acute intussusception.…”

“…Approximately 74 intussusceptions occur annually per 100,000 infants worldwide ( 2 ). It was first described in 1674 in the younger population, it may be caused by unknown aetiology in 75% of cases ( 3 , 4 ). However, 25% of cases might be caused by underlying conditions such as Meckel's diverticulum, polyp, rheumatoid purpura, and lymphoma ( 5 , 6 ).…”

Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases

“…The most common symptoms and signs for childhood intussusception are vomiting, abdominal pain, abdominal mass, and blood mixed stools, and it occurs in various proportions. 3 4 6 12 24 25 26 27 28…”

Effect of manipulative reduction combined with air enema on intestinal mucosal immune function in children with intussusception

“…10 The diagnosis and treatment of acute intussusception is mainly air enema, which is not only the diagnostic method of acute intussusception, but also the first choice of treatment for acute intussusception. [11][12][13] It was reported that the success rate of air enema treatment of acute intussusception can be 90%. 14 The pressure of the air enema is generally maintained at 6~13kpa.…”