Related Experiment Videos
Perinatal intussusception in premature infants
D P Mooney1, G Steinthorsson, N A Shorter
1Department of Surgery, Children's Hospital at Dartmouth, Lebanon, NH, USA.
Journal of Pediatric Surgery
|May 1, 1996
Summary
Intussusception is rare in premature infants, often misdiagnosed as necrotizing enterocolitis. Early diagnosis and surgical intervention are crucial for better outcomes in these high-risk neonates.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
Background:
- Intussusception is a common pediatric surgical emergency, typically affecting infants aged 5-18 months.
- Reports of intussusception in premature infants are exceptionally rare, with only 12 documented cases prior to this review.
Observation:
- This review examines 9 prior cases and 1 new case of intussusception in premature infants.
- Common clinical signs included bilious emesis, bloody stool, and intestinal dilation, often leading to misdiagnosis as necrotizing enterocolitis.
- Diagnostic challenges were evident, with contrast enema identifying intussusception in only 1 of 7 cases.
Findings:
- The average delay between symptom onset and surgery was 12 days due to misdiagnosis.
- Most cases required surgical diagnosis and successful primary anastomosis, with no reported recurrences.
- A pathological lead point was identified in 20% of the cases.
Implications:
- These rare cases may represent intrauterine development of intussusception, potentially leading to small bowel atresia if not for premature delivery.
- The high mortality rate (23%) underscores the severity and complexity of intussusception in premature neonates.
- Successful surgical management, primarily through anastomosis, is feasible, but hydrostatic reduction should be avoided.