Abstract
Background: Intussusception is a common cause of obstruction in Paediatric patients. Recognizing and treating this condition rapidly is important to prevent potentially fatal complications. Methods: Fifty consecutive patients of intussusception were analyzed with respect to age, presenting symptoms with duration, laboratory and radiological findings, type of management, duration of hospital stay and follow-up. Results: The median age at presentation was 11 months. Patients presenting between 3 months and 2 years of age are more likely to require operative intervention. The most common presenting symptoms were abdominal pain and vomiting. The diagnosis of intussusception was made by Ultrasonography and a trial of non-operative intervention was given first by in the form of USG guided hydrostatic reduction. Most of the patients required two or lesser attempts of reduction and were thus managed non-operatively. Those who did not respond to 2 or more attempts of hydrostatic reduction required operative intervention and all of these had some or the other lead point. Eight out of 11 operated patients (72.72%) required resection for the gangrenous bowel segment. The most common type of intussusception was ileo-colic and most of them were idiopathic. Lead points were found in all the patients who were operated; the most common being enlarged mesenteric lymph nodes. Conclusion: Children presenting between 3 months to 2 years of age, with no palpable abdominal lump or passage of red currant jelly-like stools as symptoms and getting reduced hydrostatically at one or two attempts mostly have idiopathic intussusception and such patients won’t require operative intervention.
Highlights
Intussusception is the invagination of one part of the bowel into another
This is a prospective observational non-randomized study done on fifty consecutive children who presented with clinical suspicion of intussusception
Non-operative intervention in the form of hydrostatic reduction was successful in 38 patients (76%)
Summary
It is one of the most frequent causes of acute bowel obstruction in infants and toddlers and the second most common cause of acute abdominal pain in preschool children after constipation [1, 2] Recognizing and treating this condition rapidly is important to prevent potentially fatal complications [3]. Patients presenting between 3 months and 2 years of age are more likely to require operative intervention. Conclusion: Children presenting between 3 months to 2 years of age, with no palpable abdominal lump or passage of red currant jelly-like stools as symptoms and getting reduced hydrostatically at one or two attempts mostly have idiopathic intussusception and such patients won’t require operative intervention
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