Itinerary of children in the management of intussusception: the true reasons of delayed medical care in a west African country


  • Missoki Azanlédji Boume Université de Kara
  • Kwami Edem Edoh Bikor Université de Lomé
  • Amivi Alice Donou Université de Lomé
  • Gamedzi Komlatsè Akakpo-Numado Université de Lomé



transient intussusception, Children, Intestinal obstruction


Background: The delayed medical care of intussusception is still the reason for morbidity and mortality in many developing countries. The objective of this study is to take stock of the itinerary of children treated for intussusception, in order to to reduce the delay of the treatment.

Methods: This is a cross-sectional study, carried over three years (from 1st June 2016 to 31 May 2019), at a Paediatric Surgery department of Campus Teaching Hospital in Lomé (Togo). The medical record of 23 children whose median age was 12 months, were included. Symptoms, the average time before the first consultation, different health centres consulted and treatment received, and the average time before the admission in the specialised department were studied.

Results: In three years, 23 children were managed for intussusception. The average time before the first consultation from home in a health centre was 1.87 days. No patient was admitted to the Paediatric Surgery department directly from home. Twelve patients consulted one centre, eight patients 2 centres, and one patient 3 centres before admission. Before referral, these patients were misdiagnosis as gastro-enteritis in 8 cases (38.10%), malaria in 8 cases (38.10%), and digestive salmonellosis in 3 cases (14.29%). The time elapsed between the beginning of the disease and the admission in specialised service was on average 5.39 days and  3.52 days elapsed then between the first consultation from home and the admission to the Paediatric Surgery service.

Conclusion: Valuable time to manage intussusceptions is lost in other medical health services before admission to specialised services. Action on this route will have to be taken through an effective counter-referral system.


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Applegate KE. Intussusception in children: evidence-based diagnosis and treatment. Pediatr Radiol. 2009; 39:140–3.

Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood intussusception: a literature review. PLoS One. 2013; 8:e68482.

Gross RE. The surgery of infancy and childhood: Its principles and techniques. Chicago: WB Saunders Philadelphia; 1953.

Ekenze SO, Mgbor SO. Childhood intussusception: The implications of delayed presentation. Afr J Pediatr Surg. 2011; 8:15-8.

Akakpo-Numado GK, Boume MA, Gnassingbe K, et al. Management and prognosis of intussusceptions in children at the Tokoin Teaching Hospital in Lomé (Togo). J Afr Chir Digest. 2012; 12:1274–80.

Charles T, Penninga L, Reurings JC, Berry MCJ. Intussusception in Children: A Clinical Review. Acta Chirurgica Belgica 2015; 115:327-33.

Xiaolong X, Yang W, Qi Wang, Yiyang Zhao, Guobin Chen, Bo Xiang. A randomized trial of pneumatic reduction versus hydrostatic reduction. J Pediatr Surg 2018; 53:1464-68.

Kelley-Quon LI, Arthur LG, Williams RF, Adam B. Goldin, Shawn D. St. Peter, Alana L. Bere. et al. Management of Intussusception in Children: A Systematic Review. J Pediatr Surg. 2020; 56: 587-96.

Edwards EA, Pigg N, Courtier J, Zapala MA, MacKenzie JD, Phelps AS. Intussusception: past, present and future Pediatr Radiol 2017; 47:1101–08.

Talabi AO, Sowande OA, Etonyeaku CA, Adejuyigbe O. Childhood intussusception in Ile-Ife: What has changed? Afr J Paediatr Surg 2013; 10:239-42.

Chalya PL, Kayange NM, Chandika AB. Childhood intussusceptions at a tertiary care hospital in northwestern Tanzania: a diagnostic and therapeutic challenge in resource-limited setting. Ital J Pediatr 2014; 40:28.

Ogundoyin OO, Olulana DI, Lawal TA. Childhood intussusception: Impact of delay in presentation in a developing country. Afr J Paediatr Surg 2016; 13:166–9.

Wasseem M, Rosenberg HK. Intussusception. Pediatr Emerg Care 2008; 24:793-800.

Applegate KE. Intussusception in children: evidence-based diagnosis and treatment. Pediatr Radiol 2009; 39:140-43.

Ito Y, Kusakawa I, Murata Y, Ukiyama E, Kawase H, Kamagata S, Ueno S, Osamura T, Kubo M, Yoshida M. Japanese guidelines for the management of intussusception in children. Pediatr Int 2012; 54:948-58.

Ajao AE, Lawal TA, Ogundoyin OO. Clinical predictors and outcome of bowel resection in paediatric intussusception. Afri Health Sci. 2020; 20:1463-70.

Columbani PM and Scholz S. Intussusception. In : Coran AG, Adzick NS, Krummel TM, Laberge JM, Shamberger RC, Caldamone AA, editors. Pediatric surgery, Philadelphia. 2012; 1093-1110.

Tareen F, Ryan S, Avanzini S, Pena V, Mc Laughlin D, Puri P. Does the length of history influence the outcomes of pneumatic reduction of intussusception in children? Pediatr Surg Int 2011; 27:587-89.

Beres AL, Baird R. An institutional analysis and systematic review with meta-analysis of pneumatic versus hydrostatic reduction or pediatric intussusception. Surgery 2013; 154:328-34.

Digant SM., Rucha S, Ekta D. Ultrasound guided reduction of an ileocolic intussusception by a hydrostatic method by using normal saline enema in paediatric patients : A sudy of 30 cases. J Clin Diagn Research 2012; 6:1722-25.



How to Cite

Boume MA, Bikor KEE, Donou AA, Akakpo-Numado GK. Itinerary of children in the management of intussusception: the true reasons of delayed medical care in a west African country. J Pediatr Adolesc Surg [Internet]. 2022Jan.26 [cited 2022Aug.7];2(1). Available from:
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