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Intussusception in Newcastle in a 25 year period
V T Tangi1, J W Bear, I S Reid
1Department of Paediatric Surgery, Newcastle University Medical School, New South Wales, Australia.
Insights
This study reviews 165 intussusception cases over 25 years, showing improved outcomes with specialized pediatric surgical and radiological care. Aggressive enema reduction and focused expertise reduced mortality and enhanced treatment success.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Epidemiology
Background:
- Intussusception is a significant cause of bowel obstruction in infants and children.
- Historical management strategies have varied, impacting patient outcomes.
- A comprehensive review of intussusception cases provides insights into evolving treatment efficacy.
Purpose of the Study:
- To analyze the historical trends and management outcomes of intussusception in Newcastle over 25 years.
- To evaluate the impact of specialized pediatric surgical and radiological care on intussusception treatment.
- To assess the success rates of different reduction techniques, including hydrostatic and pneumatic methods.
Main Methods:
- Retrospective analysis of 165 intussusception episodes in 153 patients from 1976-1988.
- Review of patient presentations and management results.
- Data collection focused on cases managed by specialized pediatric surgeons and radiologists.
Main Results:
- A significant reduction in mortality was observed compared to earlier periods.
- Improved success rates for hydrostatic and pneumatic reduction techniques were noted.
- The study estimated an 8% overall recurrence rate, with no recurrences in patients with identified lead points.
Conclusions:
- Concentration of intussusception management in specialized pediatric surgical and radiological teams has improved outcomes.
- Aggressive and broadened criteria for enema reduction have enhanced treatment success.
- Further investigation into the observed high incidence in doctors' families may be warranted.
Abstract:
The history of intussusception in Newcastle in a quarter of a century is presented by analysis of patient presentation and the results of management. The figures for the early years are incomplete, retrieved from one hospital in the area. For the years 1976-1988, all cases were managed by two paediatric surgeons who kept individual disease indices. One hundred and sixty-five episodes of intussusception in 153 patients were reviewed in this study. There was one death in the series, whereas there had been several in the years preceding it. There has been an improvement in the success of hydrostatic and later pneumatic reduction. These changes are attributed to the development of appropriate skills resulting from concentration of the management of this problem in the hands of paediatric surgeons and radiologists with special training and interest in paediatrics. Enema reduction has been used more aggressively in recent years and has widened criteria. In the series there were 8 patients with causal lead points, none associated with recurrence. The overall recurrence rate within the series was estimated at 8%. There seems to be a high incidence of intussusception in doctors' families.