P1036 THE DETERMINANTS OF RECURRENT PEDIATRIC INTUSSUSCEPTION AND THE EFFECT OF INTRAVENOUS DEXAMETHASONE ON ITS RECURRENCE

Abstract

Introduction: Our aim was to assess the determinants of recurrent pediatric intussusception, and to investigate whether the dexamethasone reduces the recurrent rate. Methods: We collected 84 episodes of 60 patients (mean age 2.6 years old) from August 2000 to November 2003. All patients were received ultrasound-guided normal saline reduction. They were divided into recurrent group (R group) and non-recurrent group (NR group). The clinical manifestations, ultrasonographic detected enlarged lymph nodes, intussusception type, use of dexamethasone, post-reduction NPO time and the overall outcome were compared between the two groups. Furthermore, the patients with detected enlarged lymph nodes in intussusception were divided into dexamethasone group (D group) and non-dexamethasone group (ND group). A comparison was made between the two groups. Results: Among the 84 episodes, the recurrent group had 25 and non-recurrent group had 59 episodes. Over 90% of both groups were ileo-colic intussusception. Enlarged lymph nodes were detected in 19 of 25 in R group and 27 of 56 in NR group. Vomiting was recorded in 4 of 25 in R group and 25 of 59 in NR group. There were both significantly different (p<0.05). There were total 46 episodes in the dexamethasone study. D groups had 16 and ND groups had 30 episodes. All of the intussusceptions were ileo-colic type, and were successfully treated under ultrasound-guided saline reduction. Recurrences happened in 8 episodes of the D group and 11 episodes of the ND group. There was no statistical significance (p=0.382). 7 of 8 episodes (87.5%) in D groups and 10 of 11 (90%) in ND groups, the recurrence happened within 3 days after reduction. Conclusion: In our study, the appearance of lymph nodes enlargement in the intussusception may play an important role in recurrent intussusception. However, intravenous dexamethasone did not reduce the early recurrent rate of the patients with enlarged lymph nodes.