The morbidity and mortality of right hemicolectomy for complicated intussusception in infants

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Tropical Medicine

Background:

• Intussusception is a common surgical emergency in infants.
• Late presentation is frequent in tropical Africa, leading to complications like gangrene and perforation.
• Bowel resection, including right hemicolectomy, is sometimes required.

Purpose of the Study:

• To analyze the outcomes of infants undergoing bowel resection for intussusception in tropical Africa.
• To identify risk factors and complications associated with right hemicolectomy in this population.
• To provide recommendations for reducing morbidity and mortality.

Main Methods:

• Retrospective review of 33 infants with intussusception over 11 years.
• Focus on 15 infants who required bowel resection, particularly the 10 who underwent right hemicolectomy.
• Analysis of patient demographics, clinical features, surgical procedures, complications, and outcomes.

Main Results:

• 45.5% of infants required bowel resection; 10 underwent right hemicolectomy (age 3-9 months, symptoms 3-8 days).
• Common comorbidities included dehydration (78%) and anemia (11%).
• High postoperative complication rate (67%), including anastomotic dehiscence (44%) and wound complications, leading to a 67% mortality rate.

Conclusions:

• Right hemicolectomy for intussusception in infants in tropical Africa is associated with significant morbidity and mortality.
• Late presentation, dehydration, and anastomotic complications contribute to poor outcomes.
• Urgent interventions and optimized surgical care are crucial to improve survival rates.