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Transanal protrusion of intussusceptions in children
Uchechukwu Obiora Ezomike1, Sebastian Okwuchukwu Ekenze, Innocent Ogundu Igwilo
1Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.
Insights
Transanal protrusion of intussusceptions is more common in females and linked to delayed diagnosis, older age, and increased surgical complications. This condition has a high mortality rate, underscoring the need for timely intervention.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and children.
- Transanal protrusion of intussusception is a rare but significant presentation.
Purpose of the Study:
- To review the management and outcomes of pediatric intussusception cases with transanal protrusion.
- To identify factors associated with poor outcomes in this specific presentation.
Main Methods:
- Retrospective analysis of 10 cases of intussusception with transanal protrusion.
- Data collected included patient demographics, clinical presentation, surgical findings, and outcomes.
Main Results:
- The anal protrusion rate was 16% (10 out of 62 cases).
- Patients were predominantly female, with a mean age of 22.6 months, and often presented late (mean 5.9 days).
- High rates of bowel resection (67%) and mortality (10%) were observed.
Conclusions:
- Transanal protrusion in intussusception is associated with delayed presentation and older age.
- This presentation carries a higher risk of bowel resection and mortality.
- Prompt diagnosis and management are crucial for improving outcomes.
Background:
The aim of the following study is to report our management experience and outcome of transanal protrusion of intussusceptions.
Patients And Methods:
Retrospective analysis of all cases of intussusceptions protruding through the anal opening from January 2008 to June 2013.
Results:
Of 62 cases of intussusceptions, transanal protrusion occurred in 10 patients (16% anal protrusion rate) with a male:female ratio of 2:3. They were aged 4-96 months (mean 22.6 ± 30.7, median 7.5 months). Six were infants while four were above 1 year. Duration of symptoms ranged from 2 to 14 days (mean 5.9 days ± 3.4) with only two patients presenting within 48 h. Clinical features included vomiting (100%), abdominal pains (100%), bloody mucoid stool (100%), abdominal distension (90%), and palpable left iliac fossa mass (70%). Three patients had preceding diarrhoea (30%) and two had preceding upper respiratory tract infection (20%). Duration of hospital stay ranged from 5 to 23 days (mean 12 days ± 5.6). Findings at surgery included seven ileocolic and two colocolic intussusceptions (one patient died before surgery). Operative procedures were right hemicolectomy (5), operative manual reduction (3), left hemicolectomy (1) giving a 67% bowel resection rate. One patient died giving a 10% mortality rate.
Conclusion:
Transanal protrusion occurred more in females and is associated with late presentation, older age, high bowel resection rate, and high mortality.