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The morbidity and mortality of laparotomy for uncomplicated intussusception in children
1Department of Surgery Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Insights
Laparotomy for uncomplicated intussusception in children leads to significant complications and mortality. Non-operative pressure reduction should be prioritized to avoid these risks.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Public Health
Background:
- Non-operative pressure reduction is the preferred treatment for uncomplicated intussusception in children.
- Laparotomy is frequently performed in developing countries despite its risks.
Purpose of the Study:
- To analyze the outcomes of operative reduction for intussusception in children.
- To highlight the morbidity and mortality associated with laparotomy for uncomplicated intussusception.
Main Methods:
- Retrospective analysis of 24 children who underwent operative reduction of intussusception.
- Data collected on patient demographics, symptoms, and post-operative complications.
Main Results:
- 54% of patients experienced 15 procedure-related complications, including wound infection, ileus, and incisional hernia.
- Mortality rate was 8%, with deaths attributed to aspiration pneumonia and overwhelming infection.
Conclusions:
- Laparotomy for uncomplicated intussusception is associated with significant morbidity and mortality.
- Children should benefit from non-operative pressure reduction, which is a safer alternative.
Abstract:
Non-operative management by pressure reduction is now the preferred treatment for uncomplicated intussusception in children. However, in many developing countries, laparotomy is routinely performed for such cases. This is a retrospective anlaysis of 24 children who had operative reduction of intussusception. The age range was 3 months--10 years (median 7 months) and duration of symptoms 12 hours--7 days (median 2 days). The main features were abdominal pain, vomiting and rectal bleeding. Ten (42%) patients had varying degrees of dehydration, which were corrected. At laparotomy, the intussusceptions were reduced without difficulty. Thirteen (54%) patients developed 15 procedure related complications including wound infection 6(25%), ileus 2(8%), stitch sinus 2(8%), incisional hernia 2(8%), intestinal obstruction from adhesions resulting in intestinal gangrene 2(8%) and aspiration pneumonia 1 (4%). Mortality was 2( 8%) from aspiration pneumonia and overwhelming infection due to intestinal gangrene from adhesive intestinal obstruction respectively. Laparotomy for uncomplicated intussusception in children is attended by significant morbidity and mortality. Many of such intususceptions, may be successfully managed by pressure reduction and children should not be denied the benefits of this form of treatment.