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Intussusception in a private tertiary-care hospital, Bangkok, Thailand: a case series
Prasong Pruksananonda1, Krairerk Athirakul, Mingmuang Worawattanakul
1Bumrungrad International Hospital, Bangkok, Thailand. prasong@bumrungraddoctor.com
Insights
This study on childhood intussusception in Thailand found ileocolic intussusception was most common, with barium enema effective for most cases. Recurrence was observed, but no mortalities occurred.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Clinical Research
Background:
- Intussusception is a common surgical emergency in infants and young children.
- Limited epidemiological data exists for intussusception in Thailand.
- Understanding local patterns is crucial for diagnosis and management.
Purpose of the Study:
- To describe the clinical characteristics and management outcomes of intussusception in children.
- To provide baseline epidemiological data for intussusception in Thailand.
- To evaluate the effectiveness of barium enema and identify recurrence rates.
Main Methods:
- Retrospective case series of 94 children (0-14 years) diagnosed with intussusception.
- Data collected from computerized hospital records (2000-2005).
- Analysis of demographics, clinical presentation, intussusception site, intervention, and outcomes.
Main Results:
- Ileocolic intussusception was most frequent (62.6%).
- Barium enema was used in 89.4% of cases, with 11.9% requiring surgery.
- No mortalities were recorded; 7-day recurrence-free probability was 84.9%.
Conclusions:
- Intussusception in Thailand presents with varied symptoms, often lacking the classical triad.
- Barium enema is an effective primary treatment, with low rates of surgical intervention and recurrence.
- This study establishes essential baseline data for future research and clinical practice in Thailand.
Abstract:
This was a retrospective case series study of patients with intussusception at a private tertiary-care hospital in Bangkok, Thailand. The computerized hospital records of all 94 children aged 0-14 years diagnosed with intussusception from 2000 to 2005 were reviewed. About half (51.1%) were males, 23.4% were less than 1 year old. Most (78.7%) were Thai nationals. The highest case frequency was in August (n=12, Poisson means = 7.8, 95% confidence interval 6.3-9.6). Of these, none had the classical triad of vomiting, colicky pain, and mucous bloody stools. Only 12.8% had fever; abdominal mass was detected in 4.3%, and 4.3% had increased bowel sounds, while 34.0% had no specific signs. The most frequent site of intussusception was the ileocolic (62.6%). Stool cultures for bacteria and stool for rotavirus antigen obtained in some cases revealed no significant findings. Of the cases, 10 (10.6%) had spontaneous reduction, 84 (89.4%) underwent barium enema intervention, 10 of the latter (11.9%) required further surgical intervention. There were no mortalities during the observation period. There were 10 recurrent events in this series. The 7-day recurrence-free probability was 84.9% (95% CI 49.2, 96.3%). This study provides baseline data regarding intussusception in Thailand which may be useful for future epidemiological and/or clinical studies.
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