Delayed presentation of intussusception in children–a surgical audit

Abstract

Background The preferred modality of treatment of intussusception is radiologic reduction; however, the situation is different in our setup, in which surgery is the only possible treatment modality to salvage patients. This study presents the management of patients of intussusception in our setup with delayed presentation, in which surgery becomes necessary to save life. Patients and methods This retrospective study included reviewing the records of all patients having intussusception. The patients were evaluated for their age of presentation, sex, duration of symptoms before presenting to the hospital, type of intussusception, complications of surgery, mortality, and follow-up. Results The study duration was 9 years and included 95 patients. The male-to-female ratio was approximately 2.5 : 1. The mean age at presentation was 3.24 ± 2.49 years. The mean duration of symptoms before presenting to the hospital was 6.08± 1.38 days. The presenting features were vomiting in 95 patients (100%), distension of theabdomen in 67 patients (70.5%), lump in the abdomen in 61 patients (64%), and bleeding per rectum in 10 patients (10.5%). Eighty-six patients (90.5%) had ileocolic or ileoileocolic intussusception. Resection was required in 75 patients (79%). The mortality rate in this study was 10.5%. Conclusion Despite the advances in the diagnosis and treatment of intussusception, a large number of children in the developing world still present very late. Hence, the treating surgeon must be ready to manage this entity effectively. Proper clinical evaluation, resuscitation, and treatment as per the condition of the patients yield good results. Keywords: bowel obstruction, children, delayed presentation, intussusceptions, surgery