Etiologic and therapeutic aspects of intussusception in childhood

Abstract

Fifty-two instances of intussusception in fortynine patients treated at the Hadassah University Hospital during a fifteen year period were analyzed. Intussusception was reduced with no subsequent complications in 47 per cent of the children who underwent barium enema reductions. Recurrence of intussusception occurred in 6 per cent, all of them successfully reduced again by barium enema. Sixty-five per cent of the patients underwent operation, of whom seven had pathologic lead points (lymphosarcoma, Meckel's diverticulum, leiomyoma, and intestinal polyp). Our experience and the collected evidence in the literature indicate the importance and usefulness of the barium enema examination as an excellent diagnostic and therapeutic modality in intussusception. Only when incomplete or uncertain reduction occurs should operative intervention be undertaken. The only contraindication to barium enema should be very marked intestinal obstruction or peritonitis. Regarding the etiology of idiopathic intussusception, we believe that hypertrophy of the lymphatic tissue in the terminal ileum, reactive to some common diseases of infancy and childhood, is a major causative factor.