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[Intestinal intussusception in children]
A Baracchini1, G Chiaravalloti, S Quinti
1Istituto di Clinica Pediatrica, Università degli Studi, Pisa.
Insights
Enteric intussusception is a common cause of acute abdomen in young children. This study reviewed 30 cases, analyzing clinical presentations and treatment outcomes for this pediatric condition.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Context:
- Enteric intussusception is a frequent cause of acute abdomen in early childhood.
- Incidence is 1.3-2/1000 children, peaking between 3-12 months.
- Primary intussusception linked to peristalsis disorders or Peyer's patch hypertrophy; secondary intussusception due to intestinal wall injury.
Purpose:
- To analyze clinical presentations and management of enteric intussusception in children.
- To evaluate the effectiveness of diagnostic and therapeutic interventions.
Summary:
- Retrospective review of 30 pediatric cases (1 month to 2 years) at the Pediatric Clinic of Pisa.
- Clinical presentations included typical (60%), atypical (16%), subacute (13%), and recurrent (10%) forms.
- Diagnosis confirmed by rectal bleeding or opaque enema; hydrostatic reduction successful in 40%, surgery in 60%.
Impact:
- Highlights the diverse clinical spectrum of enteric intussusception in children.
- Emphasizes the role of rectal bleeding and opaque enema in diagnosis and management.
- Provides insights into surgical versus non-surgical treatment outcomes for pediatric intussusception.
Abstract:
Enteric intussusception is one f the most frequent causes of acute abdomen in early childhood, with an incidence of 1.3-2/1000 children born and higher frequency from the third to the twelfth month. Primary intussusception is related to predisponsing factors such as peristalsis disorders or Peyer's patch hypertrophy induced by viral infection. Secondary intussusception is due to organic injury in the intestinal wall. The most involved sites are the terminal ileum and the ileocecum, the most frequent type is ileocolic intussusception. Many clinical forms exist, including acute enteric intussusception with its pathognomonic triad intermittent abdominal pain, emesis and rectal bleeding and the atypical form with a neurological presentation, where sopor, myosis and muscular atonicity are dominating, Intussusception can also present in a subacute or chronic form with a slow and apsecific onset. In a retrospective investigation we examined 30 cases of intussusception in children hospitalized at the Pediatric Clinic of Pisa from the 1960s up to today. Our patients (16 males and 14 females) were aged between one month and two years. Clinical presentations resulted in; typical forms (60%), atypical forms (16%), subacute forms 13%) and recurrent forms (10%). Clinical suspicion was confirmed either by the presence of blood observed during rectal exploration, which is a pathognomonic sign, or by the opaque enema which led to recovery by means of hydrostatic reduction in 40% of the cases. The remaining patients (60%) underwent surgery.(ABSTRACT TRUNCATED AT 250 WORDS)