Childhood intussusception in north eastern Nigeria: a review of its surgical management

Abstract

Background: Intussusception is the commonest cause of intestinal obstruction in the 3 months to 2 years age group. Adequate awareness of its presenting features is important for an early diagnosis and treatment. Aim: To present an experience of its surgical management in Nigerian infants and children. Setting: The University of Maiduguri Teaching Hospital. Methods: A retrospective study of patients with intussusception seen and treated between January 1999 and December 2002 was done. Their case files were studied for age, sex, presentation, definitive treatment and outcome of treatment. These were analyzed using tables. Results: Thirty-seven infants and children were seen during the study period. There were 24 males (64.8%) and 13 females (35.1%). The male to female ratio was 1.8:1. The mean age was 14.7 ± 22.61 months (range 2 months - 8 years). Twenty-two (59.4%) of the patients were aged between 3 and 9 months and 25 (67.5%) were below one year. The commonest presenting symptoms were abdominal pain (86.4%), vomiting (75.6%) and palpable abdominal mass (54.0%). Twenty-one patients (56.7%) presented to hospital latter than 72 hours from the onset of symptoms. At laparotomy, the commonest type of intussusception was ileocolic (48.6%). Twenty-three (62.1%) patients had simple manual reduction while 14 (37.8%) had bowel resection and anastomoses. There was no recurrence of intussusception after a mean follow-up of 27.8 ± 29.5 weeks. The mortality rate was 16.2%. Conclusion: Intussusception is a common cause of intestinal obstruction in infants and children in this environment. Late presentation is common and accounts for the high mortality. Outcome of treatment can be improved with high index of suspicion Keywords: Intussusception, Infants, Childhood, Surgical and non-surgical reductionPort Harcourt Medical Journal Vol. 3 (1) 2008: pp. 27-31