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Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms
Tuğba Acer-Demir1, Lütfi Hakan Güney1, Ender Fakioğlu1
1From the Department of Pediatric Surgery, Başkent University, Ankara, Turkey.
Insights
Intussusception in children often presents with vomiting and abdominal pain. Early ultrasound (USG) is recommended for diagnosis, especially in infants, to improve outcomes and reduce mortality.
Area of Science:
- Pediatric Surgery
- Emergency Medicine
- Diagnostic Imaging
Background:
- Intussusception is a common pediatric surgical emergency.
- Understanding current clinical characteristics is crucial for timely diagnosis and management.
Purpose of the Study:
- To analyze the current clinical characteristics of intussusception in children.
- To identify factors influencing presentation and outcomes.
Main Methods:
- Retrospective review of 209 children diagnosed with intussusception (January 2009 - August 2022).
- Patients grouped by symptom duration (≤12h, ≤24h) and age (<1 year, <2 years).
Main Results:
- Vomiting (70.8%) and abdominal pain (60.6%) were most common; classical triad in 4.3%.
- Younger children (<2 years) showed more irritability, bloody stool, and recurrence.
- Delayed presentation (>12h) correlated with diarrhea, fever, and recurrence.
Conclusions:
- Abdominal ultrasonography (USG) is recommended for diagnosing intussusception in young children with abdominal pain/vomiting.
- Increasing USG availability and public education on early medical help are advised in high-mortality regions.
Objectives:
Intussusception is one of the most common surgical emergencies in children. We aimed to analyze the current clinical characteristics of intussusception.
Methods:
We retrospectively reviewed 209 children diagnosed with intussusception, who were admitted to our hospital between January 2009 and August 2022. We grouped the patients according to symptom duration (before and after 12 hours and before and after 24 hours) and age (younger and older than 1 year, and younger and older than 2 years).
Results:
The median age at admission was 31 months (2-204 months). The median symptom duration was 12 hours (1-420 hours). Most patients (91.4%) were admitted due to abdominal pain, irritability, and/or vomiting. The most common symptoms were vomiting (70.8%) and abdominal pain (60.6%). The classical triad of symptoms was seen in 9 cases (4.3%). In patients aged younger than 1 year, bloody stool, abnormal abdominal radiography findings, and a longer intussusceptum segment were more frequent. In patients aged younger than 2 years, abdominal pain, fever, and defense on physical examination were less frequent, and irritability, bloody stool, and recurrence were more frequent. Patients aged younger than 2 years had a longer intussusceptum segment and less lymphadenopathy based on ultrasonography (USG). The patients admitted more than 12 hours after symptom onset had more diarrhea, fever, abnormal x-ray, peritoneal fluid on USG, and recurrences, and less vomiting. After the symptoms had lasted for 24 hours, fever, mass palpation, and abnormal abdominal radiography findings were more frequent.
Conclusions:
We recommend performing abdominal USG, especially in young children admitted to the emergency department with complaints of abdominal pain and/or vomiting, to rule out intussusception. In countries that have reported a high mortality rate from intussusception, we advise precautions such as increasing the availability of USG in emergency departments and educating the population to seek early medical assistance.
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