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Published on: December 1, 2012
Clinical predictors and outcome of bowel resection in paediatric intussusception
Akinlabi E Ajao1, Taiwo A Lawal2, Olakayode O Ogundoyin2
1Department of Surgery, Bowen University Iwo and Bowen University Teaching Hospital, Ogbomoso, Nigeria.
Insights
Surgery for intussusception in developing nations often requires bowel resection. Infants with prolonged abdominal pain and distension are more likely to need resection, leading to increased complications and longer hospital stays.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Public Health in Developing Countries
Background:
- Surgery is the primary treatment for intussusception in developing countries, resulting in high rates of bowel resection.
- High-income countries are increasingly using non-operative reduction methods for intussusception.
Purpose of the Study:
- To identify factors linked to bowel resection in childhood intussusception.
- To evaluate the outcomes of bowel resection for intussusception in children.
Main Methods:
- Retrospective review of 121 children with intussusception (Jan 2006-Dec 2015) at University College Hospital, Ibadan, Nigeria.
- Patients were categorized based on the need for bowel resection.
- Statistical analysis was performed using SPSS version 23.
Main Results:
- 53.8% of children (n=53) required bowel resection, with right hemicolectomy being the most common procedure (75.5%).
- Factors associated with resection included fever, abdominal pain, distension, rectal mass, age < 12 months, heart rate > 145/min, and symptom duration > 2 days.
- Age and abdominal pain were independent predictors for resection. Bowel resection correlated with increased post-operative complications and prolonged hospital stay.
Conclusions:
- Infants presenting with abdominal pain and distension beyond two days of symptom onset have a higher likelihood of requiring bowel resection.
- Bowel resection for intussusception is associated with a significant increase in post-operative complications and extended hospital stays.
Introduction:
Surgery remains the mainstay in treating intussusception in developing countries, with a correspondingly high bowel resection rate despite a shift to non-operative reduction in high-income countries.
Objective:
To assess factors associated with bowel resection and the outcomes of resection in childhood intussusception.
Methods:
A review of children with intussusception between January 2006 and December 2015 at the University College Hospital, Ibadan, Nigeria. The patients were categorized based on the need for bowel resection and analysis done using the SPSS version 23.
Results:
121 children were managed for intussusception during this period. 53 (43.8%) had bowel resection, 61 (50.4%) did not require resection and 7 (5.8%) were unknown. 40 (75.5%) of the resections were right hemi-colectomy. The presence of fever, abdominal pain, distension, rectal mass, age < 12 months, heart rate > 145/min and duration of symptoms > 2 days were associated with the need for bowel resection (p < 0.05). However, only age and abdominal pain independently predicted need for resection. Bowel resection was more associated with development of post-operative complications and prolonged hospital stay (p < 0.05).
Conclusion:
Infants presenting with abdominal pain and abdominal distension after two days of onset of symptoms were more likely to require bowel resection. Resection in intussusception significantly increased post-operative complications and length of hospital stay.
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