A comparison of colo-colic and ileo-colic intussusception

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Clinical Epidemiology

Background:

• Intussusception is a common surgical emergency in infants and children.
• Clinical presentation and outcomes of intussusception vary geographically.
• African pediatric intussusception cases exhibit distinct features compared to those in temperate regions.

Purpose of the Study:

• To compare the clinical and pathological features of pediatric intussusception in South Africa with those reported in temperate countries.
• To define clinically significant differences between ileo-colic and colo-colic intussusception in a South African pediatric population.

Main Methods:

• Retrospective review of 192 pediatric intussusception cases over 10 years at King Edward VIII Hospital, Durban, South Africa.
• Comparison of clinical and pathological data between 158 ileo-colic and 34 colo-colic intussusception cases.
• Statistical analysis to determine significant differences between patient groups.

Main Results:

• South African patients were older (median 1.7 years) and presented later (median 4.2 days) compared to temperate regions.
• Colo-colic intussusception occurred in older children (median 3.8 years) with fewer signs of shock and higher nonoperative reduction rates.
• Ileo-colic intussusception was associated with higher mortality and complication rates, notably a significantly higher resection rate (P < .001).

Conclusions:

• Pediatric intussusception in South Africa demonstrates unique epidemiological and clinical characteristics.
• Colo-colic intussusception in children has a better prognosis than ileo-colic intussusception, despite similar surgical intervention rates.
• Delayed presentation and higher complication rates in ileo-colic intussusception necessitate tailored management strategies in this setting.