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[Intussusception in children]
1Paediatrisk og organkirurgisk afdeling, Randers Centralsygehus.
Insights
Early diagnosis of intussusception in children improves non-operative treatment success. The classical triad is absent in many cases, highlighting the need for prompt evaluation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Context:
- Review of 22 pediatric intussusception cases treated between 1975-1989.
- Gastroenteritis was the most common misdiagnosis prior to admission.
Purpose:
- To analyze diagnostic accuracy, treatment outcomes, and clinical presentation of intussusception in children.
- To evaluate the efficacy of barium enema reduction versus surgical intervention.
Summary:
- Intussusception symptoms include vomiting, abdominal colic, palpable mass, bloody/mucus stools, and fever. Barium enema success rates were low (29%), particularly for symptom durations over 24 hours.
- Early diagnosis correlated with higher success rates for non-operative treatment.
- The classical triad of symptoms was present in only 41% of cases, emphasizing that its absence does not rule out intussusception.
Impact:
- Highlights the importance of early diagnosis for successful non-operative intussusception management in children.
- Suggests that clinical suspicion should remain high even without the classic symptom presentation.
- Provides data on treatment outcomes and hospital stay durations for different interventions.
Abstract:
The records of 22 children (sex rate boy/girl 1.75, mean age 2 7/12 year) treated for intussusception in Randers Central Hospital during the period 1975-1989 were reviewed. In 27% of the cases this diagnosis was made before admission, gastroenteritis being the most frequent differential diagnosis (18%). The mean duration of symptoms before admission was 24 hours. No significant correlation between low age and late diagnosis was found. Symptoms were vomiting (100%), abdominal colic (95%), palpable abdominal tumour (73%), diarrhoea with blood and mucus (63%) and low-grade fever (64%). Treatment by barium enema had a low success-rate (29%); the best results were recorded in children with symptoms for less than 24 hours. The mean duration of the hospital stay was 3.5 days in children treated by barium reduction and 8.5 days in children treated surgically. Early diagnosis seems to increase the success-rate of non-operative treatment. Absence of the classical triad of paroxysmal pain, abdominal mass and red currant jelly stool (found in 41% of the cases) does not exclude the possibility of intussusception.