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Recurrent Intussusception: when Should Surgical Intervention be performed?

Wei-Lun Hsu1, Hung-Chang Lee, Chun-Yan Yeung

  • 1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.

Pediatrics and Neonatology
|October 23, 2012
PubMed

Insights

Surgery for recurrent intussusception is recommended after the third episode. The probability of recurrence and need for surgery increases significantly with each subsequent episode, reaching 70% after the third event.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Intussusception is a common surgical emergency in infants and children.
  • Recurrent intussusception can lead to increased morbidity and necessitate surgical intervention.

Purpose of the Study:

  • To determine the optimal timing for surgical intervention in cases of recurrent intussusception.
  • To analyze the recurrence rates and success of non-operative management in pediatric intussusception.

Main Methods:

  • Retrospective review of medical records of 686 pediatric patients diagnosed with intussusception between 1995 and 2010.
  • Analysis of recurrence rates, success of barium enema reduction, and outcomes of surgical intervention based on the number of intussusception episodes and patient age.

Main Results:

  • The recurrence rate after barium enema reduction increased with each episode, reaching 100% after the fourth.
  • The probability of eventual surgery after the first, second, and third episodes was 21.8%, 35.7%, and 70.0%, respectively.
  • Lead points were identified in 15 children, exclusively during surgery for the first intussusception episode.

Conclusions:

  • Surgical intervention should be strongly considered after the third episode of intussusception due to a 68% recurrence rate and 70% probability of eventual surgery.
  • Early surgical consideration may be warranted in cases with identified lead points during the first episode.
Abstract

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