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Nonischemic intussusception in childhood
N S Shekhawat1, G Prabhakar, D D Sinha
1Department of Pediatric Surgery, S.P.M. Child Health Institute of S.M.S. Medical College, Jaipur, India.
Insights
Nonischemic intussusception presents atypically in older children with prolonged, milder symptoms like diarrhea, often delaying diagnosis. High suspicion is crucial for identifying this distinct clinical entity.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and young children.
- Classical symptoms include abdominal pain, bloody stools, and a palpable mass, aiding diagnosis.
- Atypical presentations, particularly in nonischemic intussusception, can lead to diagnostic delays.
Observation:
- Nonischemic intussusception is a distinct clinical entity.
- It typically affects older children with a history of less severe, prolonged symptoms.
- Diarrhea is more common in nonischemic intussusception compared to acute forms.
Findings:
- This study reviewed 31 cases of nonischemic intussusception treated over 25 years.
- Atypical presentations necessitate a high index of suspicion for accurate diagnosis.
- Delayed diagnosis is a common challenge in nonischemic intussusception.
Implications:
- Recognizing atypical symptoms is vital for timely diagnosis and management of nonischemic intussusception.
- This variant requires specific clinical consideration in pediatric patients presenting with prolonged gastrointestinal issues.
- Further research into the specific characteristics and management of nonischemic intussusception is warranted.
Abstract:
The classical presentation of intussusception consisting of severe abdominal pain, bloody stool, and a palpable abdominal mass leads to the correct diagnosis in majority of the patients. However, an atypical presentation often results in a delayed diagnosis as is commonly seen in nonischemic intussusception. The nonischemic intussusception is a distinct clinical entity that is characterized by a long history of less severe symptoms commonly noticed in older children. The incidence of diarrhea in this group is higher than in the acute variety of intussusception. This variant of intussusception requires a high degree of suspicion for the diagnosis in atypical clinical presentation. The present study summarises our experience treating 31 such cases of nonischemic intussusception during a period of 25 years from 1966 to July 1990.