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A report of 6 children with small bowel intussusception that required surgical intervention

Elisa Poh Kim Koh1, Joyce Horng Yiing Chua, Chan Hon Chui

  • 1Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore 229 899, Singapore.

Journal of Pediatric Surgery
|March 29, 2006
PubMed

Insights

Surgery is unavoidable for childhood small bowel intussusceptions (SBIs) due to pathologic lead points or complications. Air enema reduction is ineffective for SBIs, necessitating surgical intervention.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery

Background:

  • Childhood intussusception is a common surgical emergency.
  • Small bowel intussusceptions (SBIs) are rare but can lead to significant morbidity.
  • Current management strategies for SBIs require careful consideration.

Purpose of the Study:

  • To justify surgical intervention in pediatric patients with SBIs.
  • To review current concepts and management of childhood SBIs.

Main Methods:

  • Retrospective review of surgically confirmed SBI cases between July 1999 and October 2002.
  • Analysis of demographic data, clinical presentation, investigations, operative findings, and outcomes.
  • Surgical confirmation of intussusceptions in all reviewed cases.

Main Results:

  • Six cases (3.5%) of SBI were identified among 173 intussusception patients.
  • All six patients required surgery due to pathologic lead points or bowel complications.
  • Air enema reduction attempts failed in all four patients where it was tried.
  • Surgery revealed ileoileal or jejunojejunal intussusceptions, with some measuring up to 50 cm.
  • Bowel resection and primary anastomosis were performed in all cases.

Conclusions:

  • Surgical intervention is unavoidable for pediatric SBIs presenting with pathologic lead points or complications.
  • Air enema reduction is ineffective for treating SBIs.
  • Expectant management for SBIs should be approached with extreme caution.
Abstract

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