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Intussusception in children 2 years of age or older
Insights
Intussusception in children over two years old often presents with abdominal pain. Hydrostatic reduction is effective, but a high recurrence rate necessitates careful monitoring, especially in older children with potential lead points.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Medicine
Background:
- Intussusception is a common surgical emergency in infants.
- Data on intussusception in older children (2-15 years) is less extensive.
- Understanding clinical features and treatment outcomes in this age group is crucial.
Purpose of the Study:
- To review clinical features, treatment outcomes, and recurrence rates of intussusception in children aged 2 to 15 years.
- To evaluate the efficacy of hydrostatic reduction in this age group.
- To assess the association between lead points, idiopathic cases, and intussusception in older children.
Main Methods:
- Retrospective review of hospital records for 111 children aged 2-15 years treated for intussusception between 1974 and 1984.
- Analysis of clinical presentations, diagnostic methods, treatment modalities (hydrostatic reduction vs. surgery), and outcomes.
- Examination of recurrence rates and identification of potential risk factors, including lead points and underlying conditions like lymphoma.
Main Results:
- Severe intermittent abdominal pain was the primary clinical feature.
- Hydrostatic reduction demonstrated significant success, comparable to younger children and independent of symptom duration.
- A notable 20% recurrence rate was observed. Lead points were more frequent in children aged 6 years and older. Lymphoma cases presented atypically.
Conclusions:
- Hydrostatic reduction is a viable and effective treatment for intussusception in children aged 2-15 years.
- The high recurrence rate underscores the need for vigilant follow-up.
- Laparotomy to exclude lymphoma is generally not indicated without specific clinical or radiological suspicion in this age group.
Abstract:
The hospital records of 111 children aged 2 to 15 years who were treated for intussusception between mid-1974 and mid-1984 were reviewed. Severe intermittent abdominal pain was the most consistent, and frequently the only, clinical feature. Hydrostatic reduction was almost as successful as in children under 2 years of age, and its success was independent of the duration of symptoms. Most cases were idiopathic, but lead points were common in children 6 years of age or older. There was an unexpectedly high recurrence rate, 20%. In all three children with lymphoma the signs and symptoms were clearly atypical and were suggestive of pre-existing disease. In the absence of suspicious clinical or radiologic findings, laparotomy to rule out lymphoma is not warranted.