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Perforation of the intussuscepted colon

A Humphry, S H Ein, P M Mok

    AJR. American Journal of Roentgenology
    |December 1, 1981
    PubMed

    Insights

    Infants under six months with intussusception are at high risk for colon perforation during barium enema reduction. These younger, sicker infants often present with complete bowel obstruction and require surgery.

    Area of Science:

    • Pediatric surgery
    • Gastroenterology

    Background:

    • Intussusception is a common surgical emergency in infants.
    • Barium enema reduction is a standard treatment, but carries risks.

    Purpose of the Study:

    • To identify risk factors for colonic perforation during barium enema reduction for intussusception.
    • To characterize the clinical presentation of infants who experience perforation.

    Main Methods:

    • Retrospective review of hospital records for nearly 1,000 infants and children with intussusception over 25 years.
    • Analysis of outcomes for approximately 850 patients who underwent barium enema reduction.

    Main Results:

    • Six patients (all ≤ 6 months old) experienced colonic perforation during barium enema.
    • These infants presented with severe symptoms including complete bowel obstruction, lethargy, dehydration, and prolonged illness (>36 hours).
    • Perforations occurred in areas of necrotic, ischemic colon, necessitating right hemicolectomy.

    Conclusions:

    • Younger infants (< 6 months) with intussusception and complete bowel obstruction are at significantly increased risk for barium enema-induced colonic perforation.
    • Clinical presentation of these high-risk infants includes severe illness, dehydration, and prolonged symptoms.
    • Barium enema carries a substantial risk of perforation in this vulnerable pediatric population.

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