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Intussusception in infancy and childhood. Analysis of 385 cases
Insights
Intussusception is common in infants under 12 months, with rectal bleeding as a key symptom. Barium enema reduction is successful in 66% of cases, though recurrence is possible.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common cause of intestinal obstruction in infants.
- Early diagnosis and management are crucial for favorable outcomes.
Purpose of the Study:
- To analyze the clinical characteristics and treatment outcomes of intussusception in a large patient cohort.
- To identify factors influencing the success of barium enema reduction.
Main Methods:
- Retrospective analysis of 385 consecutive intussusception cases treated between 1982 and 1987.
- Evaluation of patient demographics, symptoms, duration of illness, and treatment modalities.
- Assessment of reduction success rates and recurrence patterns.
Main Results:
- The majority of patients (79%) were under 12 months of age, with a male predominance (2.2:1 ratio).
- Rectal bleeding, abdominal pain, and vomiting were the most frequent symptoms.
- Barium enema reduction was successful in 66% of patients, with a 32% recurrence rate.
- Patient age, palpable mass, lethargy, and abdominal distension influenced barium enema reduction success.
Conclusions:
- Intussusception predominantly affects infants, presenting with characteristic symptoms.
- Barium enema is an effective initial treatment, but recurrence necessitates careful monitoring.
- Clinical factors can predict the success of non-operative reduction, guiding treatment decisions.
Abstract:
A consecutive series of 385 patients with intussusception treated between January 1, 1982 and December 31, 1987 was analysed. Male patients predominated over female by a ratio of 2.2:1. Seventy nine per cent of patients were under 12 months of age. There was no seasonal variation in the incidence of intussusception. Rectal bleeding was the most common symptom, followed closely by intermittent abdominal pain and vomiting. The duration of symptoms at the time of admission was less than 24 hours in 62%. Barium enema reduction was used initially in most patients. Successful reduction by barium enema alone was obtained in 66% of patients. Thirty two patients experienced recurrence of intussusception, six following operative reduction and 26 following barium enema reduction. Five patients experienced two recurrences each. Several factors including the age of the patients, the presence of a palpable mass, lethargy and abdominal distension were identified as influencing the success rate of barium enema reduction.