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Childhood intussusception
R P Skipper1, C R Boeckman, R L Klein
1Department of Surgery, Children's Hospital Medical Center, Akron, Ohio.
Insights
Barium enema is the preferred treatment for childhood intussusception, successfully reducing 59% of cases. Surgery is reserved for unsuccessful barium enema reductions, with a low mortality rate of 1.3%.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Intussusception is a common and significant surgical emergency in children.
- Current management involves barium enema and, if necessary, laparotomy.
- Evaluating treatment outcomes is crucial for optimizing pediatric intussusception care.
Purpose of the Study:
- To assess the effectiveness and outcomes of current intussusception treatments.
- To compare the success rates of barium enema reduction versus surgical intervention.
- To establish the optimal therapeutic approach for childhood intussusception.
Main Methods:
- Retrospective review of 169 pediatric patients diagnosed with intussusception.
- Analysis of treatment modalities: barium enema reduction and laparotomy.
- Documentation of reduction success, complications, and mortality rates.
Main Results:
- Intussusception confirmed in 157 patients.
- Successful barium enema reduction in 92 patients (59%).
- Laparotomy required for 64 patients (41%), with 34 manual reductions (22%) and 30 resections (19%).
- Overall mortality rate was 1.3% (2 patients).
Conclusions:
- Hydrostatic barium enema reduction is the primary treatment of choice for childhood intussusception.
- Laparotomy should be reserved for cases where barium enema reduction fails.
- The study supports the established treatment algorithm for pediatric intussusception.
Abstract:
Intussusception of the intestine continues to be a significant surgical disease of childhood. The currently accepted therapy is to do a barium enema, followed by a laparotomy, if necessary. To evaluate our results in treating this disease, the charts of the last 169 patients admitted to the hospital, with the diagnosis of intussusception, were reviewed. Intussusception was confirmed in 157 patients, 92 of whom underwent successful reduction by barium enema (59 per cent). Sixty-four were treated with laparotomy (41 per cent). Of these 64, 34 were reduced manually (22 per cent) and 30 required resection (19 per cent). Two patients died (1.3 per cent). Our experience is in general agreement with that of other reported series, and we conclude that hydrostatic barium enema reduction is the treatment of choice for intussusception during childhood. Laparotomy should be reserved for those patients in whom the barium enema was unsuccessful.