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Updated: Apr 15, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Pathologic leadpoint is uncommon in ileo-colic intussusception regardless of age
Jill C Rubinstein1, Lucy Liu1, Michael G Caty1
1Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
Insights
In older children, ileocolic intussusception is often idiopathic, not linked to pathologic leadpoints. Non-operative management for intussusception remains successful across all age groups.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and children.
- Historically, older children with intussusception were thought to have a higher incidence of pathologic leadpoints (20-25%).
Purpose of the Study:
- To determine the actual incidence of pathologic leadpoints in children with intussusception.
- To evaluate treatment success rates based on patient age.
Main Methods:
- Retrospective review of 154 intussusception cases (1998-2012).
- Analysis of factors including age, anatomic location, presence of pathologic leadpoint, and need for surgery.
- Comparison of pneumatic or barium enema reduction success rates by age.
Main Results:
- Older children (>3 years) were more likely to have a pathologic leadpoint overall (p=0.01).
- However, subgroup analysis of ileocolic intussusception showed no difference in leadpoint incidence by age (p=0.38).
- Non-operative reduction was successful in approximately 75% of cases, regardless of age (p=0.56).
Conclusions:
- The majority of ileocolic intussusceptions in older children in this series were idiopathic.
- Pathologic leadpoints were more frequent in small bowel-small bowel intussusceptions in older children.
- Non-operative management is effective for intussusception across pediatric age groups.
Purpose:
Historically, the rate of pathologic leadpoints in older children with intussusception is quoted as 20%-25%. Our anecdotal experience suggested a lower rate. We therefore compiled a case series to examine the actual incidence of pathologic leadpoint, and treatment success, by age.
Methods:
A retrospective review was performed of all patients admitted with intussusception between 1998 and 2012 and tested for differences in anatomic location, presence of pathologic leadpoint, and need for operative intervention, on the basis of age.
Results:
In total, 154 cases of intussusception were diagnosed in 141 patients (136 ileo-colic), 38 of which were in children older than 3 (29 ileo-colic). Considering all anatomic locations, older children were more likely to have a pathologic leadpoint (p-value 0.01); however subgroup analysis of ileo-colic intussusception demonstrated no difference (p-value 0.38). Additionally, there was no difference in the success of pneumatic or barium enema reduction on the basis of age (p-value 0.56).
Conclusion:
Despite historical reports of increased pathologic leadpoints in ileo-colic intussusception in older children, in this series the majority were idiopathic. Non-operative management was successful approximately 75% of the time, irrespective of age. In older age groups, there was an increased frequency of pathologic leadpoints in small bowel-small bowel intussusception.
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