A large single-center experience in management of pediatric intussusception
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Published on: December 4, 2023
Wael M A Elzeneini1,2, Eleri Cusick1
1Department of Paediatric Surgery, Bristol Royal Children's Hospital, Bristol, UK.
Insights
This study analyzed 191 children with intussusception, finding a 66% air enema success rate but a higher surgical intervention rate than expected. Outcomes varied, highlighting challenges in comparing institutional data.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Outcomes Research
Background:
- Intussusception management and outcomes were studied over a decade at a single tertiary center.
- Recent literature on intussusception was reviewed alongside clinical data.
Approach:
- A retrospective analysis included 191 children (<16 years) admitted between 2007-2016.
- Air enema was the primary reduction method, with surgery reserved for specific cases.
- Data on age, reduction rates, surgery, hospital stay, and complications were collected.
Key Points:
- 174 patients (87%) received air enema, achieving 66% reduction success with a 1.1% perforation rate.
- 26% of total admissions required bowel resection, with 61.2% of surgical cases needing resection.
- Hospital stays ranged from 3-97 days (median 7 days), with a 2% complication rate.
Conclusions:
- The study observed a higher surgical intervention and bowel resection rate compared to published literature.
- Institutional variations in intussusception outcomes are likely multifactorial.
- Incomplete data complicates direct comparisons between institutions.
Background:
The objective of this study was to present the results of a comprehensive single-center study of the management and outcome of intussusception over a 10-year period and to review the recent literature.
Methods:
A retrospective analysis was carried out of all children less than 16 years old, admitted with intussusception to our tertiary center between January 2007 and December 2016. Air enema was attempted routinely, with primary surgery reserved for selected cases. If air enema failed, open surgery was performed. The data collected included age, enema reduction rate, need for laparotomy, detail of bowel resection, hospital stay, and complications noted.
Results:
One hundred and ninety-one children presented with intussusception, totaling 200 admissions. One hundred and seventy-four patients (87%) underwent air enema. There was a complete reduction in 66% of these cases and a perforation rate of 1.1%. Twenty-six patients (13%) underwent primary surgery. Of the 59 patients with incomplete enema reduction, 50.8% required bowel resection while 49.2% required only manual reduction. Bowel resection was necessitated in 26% of total admissions and 61.2% of those requiring surgery. Hospital stays ranged from 3-97 days (median 7 days). There were four complications (2%).
Conclusion:
This comprehensive study reveals a higher rate of surgical intervention and bowel resection than was anticipated from selective series in published literature. Institutional variation in outcome is likely multifactorial but incomplete data make comparisons difficult.
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