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Intussusception in older children
Insights
Intussusception in children over two presents differently than in infants, often with subtle symptoms. Hydrostatic reduction may be suitable for older children if X-rays show no small bowel obstruction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants.
- Presentation and management in older children (>2 years) differ significantly from infants.
Purpose of the Study:
- To characterize intussusception in children over two years of age.
- To evaluate diagnostic challenges and treatment outcomes in this age group.
Main Methods:
- Retrospective review of 37 cases of intussusception in children over two years of age.
- Analysis of clinical presentation, diagnostic methods (including plain abdominal X-rays), and surgical findings.
Main Results:
- Subacute or chronic presentation was more common than in infancy.
- Rectal bleeding and palpable intussusception were infrequent.
- Diagnosis was challenging, but plain abdominal X-rays were helpful.
- Surgery was performed in the majority of cases, with a 22% incidence of lead points.
Conclusions:
- Attempted hydrostatic reduction is not contraindicated in children over two years with intussusception.
- Hydrostatic reduction should be considered only when X-rays exclude small bowel obstruction.
Abstract:
In a retrospective series of 37 cases of intussusception in children over 2 years of age, it was found that a subacute or chronic presentation was more common than in infancy, that few of them had rectal bleeding, and only a minority had a palpable intussusception. Diagnosis was often difficult but was helped by plain abdominal x-rays. Although the majority of children underwent surgery, with a 22% incidence of lead points, it is concluded that attempted hydrostatic reduction in these older children is not contraindicated, provided x-rays do not show small bowel obstruction.