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Intussusception in infancy and childhood
V Myllylä1, M Päivänsalo, O Linna
1Department of diagnostic Radiology, University of Oulu, Finland.
Insights
This study on intussusception in 41 patients found common symptoms like vomiting and pain. Early diagnosis and treatment, especially before 24 hours, significantly reduced the need for surgery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and children.
- Timely diagnosis and intervention are crucial for favorable outcomes.
Purpose of the Study:
- To review the diagnostic and treatment experiences of intussusception in a cohort of 41 patients.
- To identify key clinical features and evaluate the effectiveness of different diagnostic and therapeutic modalities.
Main Methods:
- Retrospective review of 41 pediatric patients diagnosed with intussusception.
- Analysis of presenting signs and symptoms, diagnostic methods (ultrasound, barium enema), and treatment outcomes (hydrostatic reduction, surgery).
Main Results:
- Common symptoms included vomiting (83%), colicky pain (83%), rectal bleeding (66%), and abdominal mass (51%).
- Barium enema correctly diagnosed all cases and achieved successful hydrostatic reduction in 44% (12/27) of patients.
- Laparotomy was required for reduction in 29 patients (71%), with 84% of those presenting after 24 hours needing surgery versus 59% presenting earlier.
Conclusions:
- Intussusception diagnosis relies on a combination of clinical signs, with barium enema being highly accurate.
- Prompt presentation and intervention are associated with a lower likelihood of requiring surgical management.
Abstract:
Experiences of the diagnosis and treatment of 41 patients with intussusception are presented. The most common signs and symptoms upon presentation were vomiting (83%), colicky pain (83%), rectal bleeding (66%) and abdominal mass (51%). All four features occurred together in only 20% of cases. Ultrasound was the primary mode of investigation in four children, giving a finding characteristic of intussusception. 27 patients were examined with barium enema, and hydrostatic reduction was tried. A barium enema gave the correct diagnosis on all cases and a successful reduction of sign and symptoms in 12 patients (44%). In the other 29 cases laparotomy was performed to achieve reduction, primarily in 14 patients and after an unsuccessful barium edema in 15.84% of the patients presenting after a delay of more than 24 hours needed surgery, compared with 59% of those presenting earlier.