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[Invagination in children]
A Rydning1, J A Søreide, M Berget
1Kirurgisk avdeling, Sentralsjukehuset i Rogaland, Stavanger.
Insights
Diagnosing childhood intussusception is challenging due to vague symptoms in infants. Barium enema is effective for non-operative reduction in most cases, with no major complications reported.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Context:
- Childhood intussusception is a frequent cause of small bowel obstruction in infants.
- Clinical signs and symptoms can be difficult to interpret in very young patients.
- Accurate diagnosis by referring physicians is often delayed.
Purpose:
- To evaluate the diagnostic challenges and treatment outcomes of childhood intussusception.
- To assess the efficacy of barium enema reduction for intussusception.
- To analyze complications associated with intussusception management.
Summary:
- A retrospective study of 79 children (83 episodes) with intussusception found diagnostic accuracy by referring physicians was low (about one-third).
- Non-operative treatment was attempted in 89% of cases, with barium enema reduction succeeding in 64%.
- Laparotomy was necessary in 42% of patients; no major complications or mortality occurred.
Impact:
- Highlights the diagnostic difficulties in pediatric intussusception, emphasizing the need for improved clinical recognition.
- Demonstrates the safety and effectiveness of barium enema as a primary treatment modality.
- Provides valuable data for clinicians managing intussusception, informing treatment strategies and reducing unnecessary interventions.
Abstract:
Although rare, childhood intussusception is one of the most common causes of small bowel obstruction in infancy. In these very young patients it can sometimes be difficult to interpret the clinical signs and symptoms correctly. This retrospective study comprises 79 children (median age 7.5 months; 24% girls and 76% boys) who experienced 83 episodes of intussusception. At admission the diagnosis made by the referring physicians could be confirmed in only about one-third of the cases. A barium enema was part of the inhospital diagnostic process. Non-operative treatment was attempted in 70 patients (89%), and barium enema reduction was successful in 64%. Laparotomy was required in 33 (42%) of the patients. No mortality, bowel perforation, or any other major complications were encountered. The diagnosis of childhood intussusception seems difficult to achieve in many cases, and the interpretation of, at times vague clinical signs and symptoms remains a challenge for all clinicians who are involved in the care of these very young patients.