Clinical Features of Intussusception in Children of Different Age Groups

Abstract

Objective To explore the clinical characteristics and management of intussusception in children of different age groups. Methods Retrospective analysis of the clinical information of 76 patients with intussusception who were younger than 14 years old were recruited. They treated in Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital from January 2011 to July 2013. According to different ages, they were divided into: 0-2 years group and ≥2 years old group. Their diagnoses results were confirmed by abdominal ultrasonography, pneumatic reduction or laparotomy. Clinical presentations, physical examinations, auxiliary examinations, pneumatic reduction, operations, existing of recurrences and pathological lead point(PLP) were analyzed by statistic methods. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital. Informed consent was obtained from the parents of each participating child. Results The sex and duration of manifestation were comparable in both groups, and there had no significant difference (P>0.05) . There were no significant difference in positive results of ultrasound, success rate of pneumatic reduction, operations, intestinal gangrene and recurrence between two groups (P>0.05) . There were significant difference in classic symptoms, such as red currant jelly stool, vomiting between 0-2 years group(62.1%,36/ 58) and ≥2 years old group(5.6%,1/ 18) (P<0.05) . In 0-2 years group, incidence rates of vomiting and bloody stools were reported in 75.9 % (44/ 58) and 0(0/ 58) , and corresponding frequency in ≥2 years old group were 22.2% (4/ 18) and 5.6% (1/ 18) , respectively, and had significant difference between this two groups (P<0.05) . Only one case of a PLP (ileal juvenile polyp) was found in a 6 years old girl. Conclusions Abdominal pain is the predominant presentation of intussusception in children older than 2 years old. Classic symptoms and intussusception gangrene rarely exist in this group. Pneumatic reduction is safe and effective in both groups. Though the recurrence rate may be higher than in infants, most of the patients older than 2 years were idiopathic. Key words: Intussusception; Enema; Pneumatic reduction; Child