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Early diagnosis and treatment for intussusception in children is mandatory
Martin Kobborg1, Kristine Bach Korsholm Knudsen, Inge Boetker Rasmussen Ifaoui
1mkobborg@gmail.com.
Insights
Timely diagnosis of intussusception within four hours of hospitalisation significantly improves non-surgical reduction success rates and lowers the need for bowel resection in children. This highlights the critical importance of rapid diagnosis in pediatric intussusception management.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Outcomes
Background:
- Intussusception management still necessitates surgical intervention in some pediatric cases, despite advancements in non-surgical reduction techniques.
- Understanding time-related factors is crucial for optimizing treatment strategies in pediatric intussusception.
Purpose of the Study:
- To analyze treatment data from two tertiary pediatric surgery centers.
- To identify time-dependent factors influencing the outcomes of intussusception treatment in children.
Main Methods:
- Retrospective chart review of 158 patients under 16 years old treated for intussusception (2005-2015).
- Data collected included demographics, time intervals from symptom onset to treatment completion, and complications.
- Analysis focused on the impact of diagnostic and treatment timing on surgical vs. non-surgical outcomes.
Main Results:
- Non-surgical reduction was the primary approach in 48% of cases, with an overall success rate of 32%.
- Diagnosis confirmation within 4 hours of hospital admission significantly increased non-surgical success rates (p=0.003).
- Early diagnosis (within 4 hours) and treatment initiation (within 6 hours) were associated with lower rates of bowel resection (p=0.026, p=0.033).
Conclusions:
- The study observed a low utilization and success rate for enema reduction in pediatric intussusception.
- Prompt diagnosis within four hours of hospital admission is critical for improving enema success rates.
- Timely diagnosis and treatment initiation are key to reducing the need for intestinal resection in pediatric intussusception cases.
Introduction:
In some cases, surgical treatment is necessary to manage intussusception despite advances in enema reduction. The purpose of this study was to analyse treatment in two tertiary referral university centres for paediatric surgery to identify time-related factors influencing treatment of intussusception.
Methods:
This was a retrospective two-centre chart review, performed for all patients under the age of 16 years who underwent treatment for intussusception during the period from 2005 to 2015. Demographic data and data on different time intervals from symptom debut to end of treatment and compliacations were retrieved from the medical record.
Results:
A total of 158 children were included. Non-surgical reduction was used as the primary treatment modality in 48% and intussusception was successfully reduced in 32% of these cases. The non-surgical success rate was found to be significantly higher when the diagnosis was confirmed within four hours of hospitalisation (p = 0.003). A lower rate of bowel resection was observed when the diagnosis was confirmed within four hours of hospitalisation (p = 0.026) and treatment was initiated within six hours of hospitalisation (p = 0.033).
Conclusions:
This study found a relatively low utilisation rate for enema reduction and an overall low enema success rate. The success rate of enema was significantly higher and the intestinal resection rate lower when the diagnosis was confirmed within four hours of hospitalisation, which underpins the importance of a quick and timely diagnosis.
Funding:
none.
Trial Registration:
not relevant.
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