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Intussusception in children 5-15 years of age
J A Reijnen1, H J Joosten, C Festen
1Department of General Surgery, St. Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Insights
Intussusception in older children (5-15 years) presents uniquely, often delaying diagnosis. Early surgical intervention is crucial for small bowel intussusception, while hydrostatic reduction requires careful follow-up for potential organic lesions.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception, a condition where one part of the intestine slides into another, is most common in infants.
- This study examines a less common presentation of intussusception in older children (5-15 years).
Purpose of the Study:
- To compare intussusception in older children with that in infants and early childhood.
- To analyze diagnostic delays, predisposing factors, and treatment outcomes in pediatric intussusception.
Main Methods:
- Retrospective analysis of 20 cases of intussusception in children aged 5-15 years.
- Comparison with 108 cases of intussusception in infants and younger children treated between 1964 and 1984.
- Review of diagnostic methods, surgical interventions, and follow-up procedures.
Main Results:
- Older children represented 18.5% of all treated intussusception cases.
- Delayed diagnosis was noted, likely due to atypical presentations in this age group.
- Predisposing factors were identified in 55% of cases; 45% involved small bowel intussusception requiring prompt surgery.
Conclusions:
- Intussusception in older children requires careful consideration due to potential diagnostic delays and specific predisposing factors.
- Hydrostatic reduction should be attempted when feasible, followed by diligent follow-up to rule out organic lesions.
- Surgery is indicated for recurrent abdominal complaints after hydrostatic reduction.
Abstract:
Twenty cases of intussusception in children between the ages of 5 and 15 years were compared with intussusception in infancy and early childhood. They accounted for 18.5 per cent of all 108 children treated for intussusception in two large hospitals from 1964 to 1984. Diagnosis of intussusception was delayed, probably due to an unusual presentation. Fifty-five per cent had a definite predisposing factor precipitating the intussusception and 45 per cent had a small bowel intussusception, which warranted early surgical intervention. In the absence of contraindications no child should be disqualified from an attempt at hydrostatic reduction. After hydrostatic reduction careful follow-up is required to exclude an organic lesion, possibly by a small bowel follow-through meal. Surgery is indicated after hydrostatic reduction in case of chronically recurrent abdominal complaints.