Idiopathic Intussusception in Infants and Children: Different Outcomes in Relation to Interventions

Background Intussusception is a pediatric emergency causing bowel obstruction that can progress to gangrene or perforation. Patients usually present with vomiting, abdominal discomfort or pain, or rectal bleeding. Specialized infant and child care is important to detect and manage such cases. Methodology This retrospective, cross-sectional study analyzed 45 cases of idiopathic pediatric intussusception presented to and managed by specialized pediatric healthcare services over 12 years. The medical records of children who presented with idiopathic intussusception from January 2010 to December 2022 at King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia were reviewed. The data obtained included age, sex, clinical presentation, symptom duration, diagnostic investigations, mode of treatment, length of hospital stay, and outcomes. Results A total of 45 children were included (25 male, 20 female). The median age was 10 months ranging between five and eight months. The majority presented with abdominal pain or colic (78%), vomiting (76%), and rectal bleeding (47%). The diagnosis was done by an ultrasound preceded by pneumatic enema reduction that was successful in 33 (80%) children. Only four (9%) children underwent surgery as initial management. Ileocolic intussusception (73%) was the most prevalent, followed by colicolic (18%) and ilioiliac (10%). Among the children who underwent surgical reduction, 11 (92%) underwent laparotomy reduction. In total, 11 children underwent surgical reduction as well as an appendectomy, and four children required bowel resection. Only two children developed perforation, and recurrence occurred in two other children. The mean duration of symptoms before presentation was 46.73 hours, and the mean hospital stay was 3.4 days for all cases. Rectal bleeding was a predicting factor for surgical reduction. Conclusions Ileocolic was the most common site of intussusception. Abdominal pain, vomiting, and rectal bleeding were frequently seen on presentation. In addition, surgical reduction was associated with rectal bleeding. However, pneumatic reduction was successful in 80% of the cases. Unlike the previous study, this study reports fewer children requiring surgical intervention as well as lower hospital stay duration. Thus, this study emphasizes the importance of specialized pediatric services to enhance outcomes.