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The painless intussusception
Insights
Painless intussusception in children leads to delayed presentation and less successful non-operative treatment. This often necessitates surgical intervention for intussusception reduction and resection.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and children.
- Pain is a hallmark symptom, but painless presentations occur.
Purpose of the Study:
- To compare the clinical course and treatment outcomes of children with painless intussusception versus those with painful intussusception.
- To identify factors influencing the effectiveness of non-operative management.
Main Methods:
- Retrospective review of 422 intussusception cases (1959-1970).
- Analysis of patient histories, focusing on symptom duration and treatment required.
- Comparison between children with and without recorded pain.
Main Results:
- Children with painless intussusception presented later than those with pain.
- Hydrostatic reduction was less effective in painless cases.
- Operative reduction and resection were required more frequently in children with painless intussusception.
Conclusions:
- Painless intussusception is associated with delayed diagnosis and poorer outcomes with non-operative treatment.
- Clinical vigilance is crucial, even in the absence of pain, for timely intussusception management.
Abstract:
There were 422 cases of intussusception at the Hospital for Sick Children, Toronto, over a 12-yr period between 1959 and 1970. The histories of all patients who had no pain recorded were evaluated and the duration of signs and symptoms and the treatment required assessed. When compared with those who had pain, it was noted that the children with painless intussusception presented later, hydrostatic reduction was less likely to be effective, and operative reduction and resection was required more often.