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Acute intussusception: referral in relation to presentation and aetiology
S K Jain1, M Sharma, S K Singla
1Department of Paediatric Surgery, Kalawati Saran Children's Hospital, New Delhi, India.
Insights
Delayed surgical referral in children with acute intussusception, especially those with diarrhea and rectal bleeding, is linked to worse outcomes. Ileoileal intussusception cases showed higher rates of gangrene and irreducibility.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in children.
- Timely diagnosis and surgical intervention are crucial for favorable outcomes.
Purpose of the Study:
- To analyze the relationship between presenting symptoms, time to surgical referral, and outcomes in pediatric intussusception.
- To identify factors associated with complications such as gangrene and irreducibility.
Main Methods:
- Retrospective review of 42 consecutive pediatric cases of acute intussusception.
- Analysis of presenting symptoms, time from symptom onset to surgical referral (categorized as >72 hours), operative findings, and patient outcomes.
Main Results:
- Late surgical referral (>72 hours) was observed in children presenting with diarrhea and bleeding per rectum.
- The ileoileal intussusception subtype showed a higher incidence of gangrenous bowel and irreducibility.
- Rupture of the intussuscipiens was also noted in some cases.
Conclusions:
- Presenting symptoms like diarrhea and rectal bleeding may indicate delayed presentation and increased risk of complications in pediatric intussusception.
- Early surgical referral is critical, particularly for ileoileal intussusception, to prevent gangrene and improve outcomes.
Abstract:
A study of 42 consecutive children with acute intussusception was undertaken. The emphasis was on the time taken for surgical referral in relation to the presenting symptom. Operative findings and outcome revealed late referral (greater than 72 h) in cases presenting with diarrhoea and bleeding per rectum. A higher incidence of gangrenous gut and irreducibility of intussusception was found in the ileoileal variety of intussusception. Some interesting facts about the aetiology have also been noted. Rupture of intussuscipiens was also encountered.