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[Intussusception in the Pediatric Hospital of Coimbra. 13-year results]
M F Cruz Lopes1, A M Afonso Reis, V M Andrade Rolo
1Servicio de Cirugía Pediátrica, Hospital Pediátrico de Coimbra, Portugal.
Insights
Intussusception in infants is common, with abdominal pain and vomiting as key symptoms. Hydrostatic barium enema is a successful diagnostic and therapeutic tool, though surgery may lead to complications.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Context:
- Intussusception is a common surgical emergency in infants.
- This study reviews a large cohort of pediatric intussusception cases over 13 years.
Purpose:
- To analyze the clinical presentation, diagnostic methods, treatment outcomes, and recurrence rates of intussusception in children.
- To evaluate the efficacy and safety of hydrostatic barium enema versus surgical intervention.
Summary:
- A 13-year study of 233 pediatric intussusception cases found males and infants under one year most affected.
- Abdominal pain and vomiting were primary symptoms; currant-jelly stools were less frequent. Hydrostatic barium enema achieved a 57.7% reduction success rate.
- Surgery was associated with complications and reoperations. The overall recurrence rate was 3.8%, with a 2.5% mortality rate.
Impact:
- Highlights the diagnostic and therapeutic utility of hydrostatic barium enema in pediatric intussusception.
- Provides valuable data on surgical complications and recurrence rates, informing clinical management strategies.
- Contributes to understanding the natural history and treatment outcomes of intussusception in a pediatric population.
Abstract:
We present the results from 233 consecutive patients treated for intussusception at the Children's Hospital of Coimbra over a 13-year period (between 1/6/77 and 31/5/90). Males outnumbered females (66.5% vs 33.5%) and 87.9% of the cases occurred within the first year of life. Among the presenting signs and symptoms, abdominal pain occurred in 87.9% and vomiting in 81.5%. The presence of currant-jelly stools was less common, but noted in 67.3%. Hydrostatic barium enema was performed in 94.4% of the patients with the aim being both diagnostic and therapeutic, successful reduction was achieved in 57.7%. One hundred and twenty-one patients were operated on with specific pathologic lesion found in 11.5% of them. Complications occurred only in the group submitted to surgery. Six children were reoperated on. Most intussusceptions were of the ileocecocolic variety. The overall recurrence rate was 3.8% (3% recurrent intussusceptions followed barium enema reduction and 0.8% followed manual reduction). Mortality rate was 2.5% (1.7% related to intussusception).