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[Seasonal pattern of intussusceptions in infants and children: is fall/winter predominance still worth consideration?
C Serayssol1, O Abbo1, S Mouttalib1
1Service de chirurgie pédiatrique, hôpital des enfants de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
Insights
This study found no seasonal pattern in infant intussusceptions, challenging traditional medical teaching. Further research is recommended to confirm these findings on childhood intussusceptions.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Epidemiology
Context:
- Intussusception is a critical medical and surgical emergency in infants and children.
- Traditional medical education suggests a seasonal pattern for intussusceptions, predominantly in fall and winter.
- Epidemiological data on intussusceptions in France are not well-defined.
Purpose:
- To evaluate the seasonality of idiopathic ileocolic intussusceptions in children.
- To describe the sex ratio, age of occurrence, recurrence rate, and failed enema reduction rate.
- To assess epidemiological characteristics of intussusceptions in a French cohort.
Summary:
- A 10-year retrospective study of 306 idiopathic ileocolic intussusceptions found no seasonal pattern or fall/winter predominance.
- The mean age was 18.7 months, with higher incidence in males (2:1 ratio).
- Recurrence rate was 8.2%, and surgery after failed enema reduction was 7.5%; no recurrences post-surgery.
Impact:
- Findings contradict established medical teaching regarding intussusception seasonality.
- Highlights the need for updated academic information on intussusception epidemiology.
- Provides crucial epidemiological data for pediatric intussusception management and research in France.
Introduction:
Intussusceptions in infants and children are a medical and surgical emergency. A seasonal pattern, with fall and winter predominance, is usually taught in medical schools, but in France the epidemiological characteristics of intussusceptions are not clearly described.
Methods:
We conducted a retrospective study concerning children with idiopathic ileocolic intussusceptions admitted and treated at our institution (Emergency Department and Pediatric Surgery Department, Toulouse University Hospital) between January 2002 and December 2011. The main purpose was to evaluate the seasonality of intussusceptions. We describe the sex ratio, age of occurrence, rate of recurrence, and rate of failed enema reduction.
Results:
A total of 306 idiopathic ileocolic intussusceptions (280 patients) were included over a 10-year period with an average of 31 cases per year [21-42]. No seasonal pattern of intussusceptions or fall/winter predominance was shown (P=0.6) in the cumulative number of monthly cases: 24% of the intussusceptions occurred during fall, 21% during winter, 29% during spring, and 27% during summer. There were two peaks: April (35 cases over 10 years) and June (34 cases). The mean age was 18.7 months [2.3-159.4]: 19.5 months [3-159.4] in boys and 14.8 months [2.3-77.5] for girls (P=0.02). Two peaks were shown: one between six and nine months, the other one between 18 and 21 months. Male children had a higher incidence than female children: the sex ratio was 2:1, with 65.4% boys and 34.6% girls (P=0.0003), with an increasing sex ratio for older children. The recurrence rate was 8.2% among all (26 recurrences): 10.1% in boys and 4.9% in girls (P=0.08). The rate of surgery after failed enema reduction was 7.5% (21/280 children). There was no case of recurrence after operation.
Conclusion:
These results were consistent with previous reports. We did not show any seasonal pattern of idiopathic ileocolic intussusceptions in our patients. A new survey of childhood intussusceptions would be relevant to confirm these results and would make it possible to modify academic teachings about seasonality in intussusceptions.
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