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Intussusception patients older than 1 year tend to have early recurrence after pneumatic enema reduction
Zhe Wang1, Qiu-ming He, Hong Zhang
1Guangzhou Women and Children's Medical Center, Guangzhou, People's Republic of China, wonderzhe@hotmail.com.
Insights
Children over one year old are at higher risk for early intussusception recurrence after pneumatic enema reduction. Most recurrences happen within 48 hours, and repeat enemas are effective.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and young children.
- Pneumatic enema reduction is a primary treatment modality.
Purpose of the Study:
- To identify age-related risk factors for early intussusception recurrence following pneumatic enema reduction.
- To propose management strategies for recurrent intussusception.
Main Methods:
- Retrospective analysis of 2,295 intussusception patients' medical records.
- Data collected between January 2009 and December 2011.
Main Results:
- The overall early recurrence rate after pneumatic enema was 6.62%.
- Patients older than 1 year had a significantly higher early recurrence rate (11.9%) compared to those younger than 1 year (2.1%).
- 92.1% of early recurrences occurred within 48 hours; repeat pneumatic enema was successful in 93.7% of cases.
Conclusions:
- Age over 1 year is a significant risk factor for early intussusception recurrence post-pneumatic enema.
- Hospitalization is not routinely necessary after pneumatic enema reduction.
- Repeat pneumatic enema is a viable conservative treatment before considering surgery.
Purpose:
To identify age risk factors of early recurrent intussusception after pneumatic enema reduction. Management opinions are proposed.
Methods:
Two thousand two hundred and ninety-five intussusception patients' medical records from January 2009 to December 2011 were retrospectively reviewed and analyzed.
Results:
Of the 2295 patients, the intussusception of 1917 of them was initially reduced by pneumatic enema, with 127 cases recurring within 72 h. The early recurrence rate is 6.62%. The early recurrence rate of patients younger than 1 year old is 2.1% (22/1032), while the rate for those older than 1 year is 11.9% (105/885). The difference is significant (P = 0.0001). There were no significant differences between age groups older than 1 year. One hundred and seventeen cases of recurrence happened within 48 h, which accounted for 92.1% of all early recurrence. Recurrence patients were treated again with pneumatic enema, with a successful reduction in 93.7%. They were followed up for 2-4 years; the long-term recurrent rate was 11.8% (14/119). No patient had poor prognosis because of delayed treatment.
Conclusion:
Intussusception patients older than 1 year tend to have greater early recurrence rate after pneumatic enema reduction; 92.1% of the early recurrent cases happened in 48 h. There is no need to hospitalize patients after pneumatic enema reduction. A repeat pneumatic enema is a good choice before surgical approach.
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