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Childhood intussusception: a multicentre study in a middle-income country
A E Ajao1, F O Kumolalo2, D I Olulana3
1Department of Surgery, Bowen University Iwo and Bowen University Teaching Hospital, Nigeria.
Insights
Delayed presentation of intussusception in Nigerian children is common, leading to surgery and complications. Prompt referral to pediatric surgeons can improve outcomes for childhood intestinal obstruction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Public Health
Background:
- Intussusception outcomes are well-documented in high-income countries.
- Limited data exists for middle-income countries.
- This study addresses childhood intussusception in Nigeria.
Purpose of the Study:
- Investigate presentation patterns of childhood intussusception.
- Analyze management strategies.
- Determine outcomes in a middle-income setting.
Main Methods:
- Retrospective review of 190 children.
- Multicenter study in South West Nigeria.
- Analysis of clinical data and outcomes.
Main Results:
- Median age 7 months, peak incidence 3-6 months.
- 38.4% presented with classic triad; 10.1% within 24 hours.
- 88.2% required surgery; 21.1% had complications; 5.8% mortality.
Conclusions:
- Delayed presentation remains a significant challenge.
- Early surgical referral can reduce morbidity and hospital stay.
- Improving timely management is crucial for better outcomes.
Background:
The outcome in infants and young children of intestinal obstruction due to intussusception is well documented in high-income countries. Our aim was to investigate the current pattern of presentation, management and outcome of childhood intussusception in a middle-income country using a multicentre approach.
Methods:
Records of children managed for intussusception in three centres in South West Nigeria were retrospectively reviewed and analysed.
Results:
One hundred and ninety children managed for intussusception were analysed. The male-to-female ratio was 1.8:1. The median age was 7 months with a peak age incidence of 3-6 months. Peak incidence was recorded during the dry season. Passage of bloody stool, vomiting, abdominal pain and fever were the most common presenting features. Seventy-three (38.4%) of the patients presented with the classic triad. The median duration of symptoms was three days and only 19 (10.1%) patients presented in less than 24 hours. Ileocolic intussusception was the most common anatomic type, occurring in 166 (87.4%) patients, and was significantly associated with age. Twenty-two (56.4%) had successful hydrostatic reduction, while 165 (88.2%) required surgery. Forty (21.1%) patients suffered postoperative complications. Eleven (5.8%) of the patients died. The median duration of hospital stay was six days, and this correlated with the duration of symptoms and the length of hospital stay.
Conclusion:
Delayed presentation is a persisting challenge in the management of childhood intussusception in Nigeria. Prompt referral to a paediatric surgeon may reduce the surgery rate, associated morbidity and the length of hospital stay.
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