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Trends in childhood intussusception in a Nigerian tertiary hospital
Uchechukwu Obiora Ezomike1, Emmanuel Ifeanyi Nwangwu1, Isaac Sunday Chukwu1
1Department of Pediatric Surgery, College of Medicine, University of Nigeria Teaching Hospital, Enugu.
Insights
Successful non-operative treatment for intussusception increased significantly, while operative interventions decreased. Diagnostic imaging improved, and hospital stays shortened, though late presentation and outcomes remained unchanged.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Childhood intussusception management varies globally, with lower-income countries facing challenges unlike high-income nations.
- Early diagnosis and successful non-operative treatment are key but not universally achieved.
Purpose of the Study:
- To analyze trends in intussusception patient profiles, treatment methods, and outcomes over a 12-year period.
- To identify changes in treatment strategies and their impact on patient care.
Main Methods:
- A retrospective study comparing two 6-year periods.
- Statistical analysis included t-tests and Fisher exact tests to compare treatment outcomes and diagnostic tool utilization.
- Data were analyzed using SPSS, with a p-value < 0.05 considered significant.
Main Results:
- Successful non-operative treatment rose from 18.6% to 34% (p=0.03).
- Operative manual reduction decreased (27.1% to 12.8%; p=0.026), as did overall operative treatment (78.5% to 63.9%; p=0.034).
- Ultrasound use increased (75% to 96.7%; p<0.0001), and hospital stay reduced (10.47 days to 7.24 days; p=0.004).
Conclusions:
- Non-operative treatment has become more successful, reducing reliance on operative interventions.
- Increased use of preoperative ultrasound and shorter hospital stays indicate improved care efficiency.
- Despite advancements, late presentation, morbidity, and mortality rates did not significantly change.
Background:
Early presentation, high rate of successful non-operative treatment, low morbidity and mortality in childhood intussusception is common in High and Upper Middle-Income Countries but not in many Lower middle- and Low-income countries.
Aim:
To assess the trends in the profile, treatment modalities and outcomes of intussusception in our hospital.
Materials And Methods:
Retrospective study over a 12-year period divided into two 6-year periods. Data entry/analysis was done using SPSS and various indices were compared between these two periods. Two-tailed t-test for two independent means was used to compare means while two-tailed Fisher exact tests were used to compare categorical variables. Results were presented as tables, means, ranges, percentages and a p-value less than 0.05 was deemed statistically significant.
Results:
There was a significant increase in the proportion of successful non-operative treatment (18.6% vs 34%, p=0.03), reduction in the incidence of operative manual reduction (27.1% vs 12.8%; p=0.026), reduction in operative treatment (78.5% vs 63.9%, p=0.034), increased utilization of pre-intervention ultrasound (75% vs96.7%, p<0.0001) and reduction in hospital stay duration (10.47 ±7.95days vs 7.24±4.86 days; p=0.004).
Conclusions:
Contribution of successful non-operative treatment to the overall treatment of intussusception significantly increased while that of operative manual reduction significantly reduced and bowel resection showed no change. Preoperative utilization of ultrasonography significantly increased while mean duration of admission reduced significantly, but late presentation, morbidity and mortality rates had no significant changes.
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