Single-center experience of managing childhood intussusception

Authors

  • Wajeeh Uddin Specialist Pediatric Surgeon
  • Vipul Gupta Senior Specialist Pediatric Surgeon
  • Ghadeer Jabir Consultant Pediatric Surgeon
  • Diary Abdulrahman Mohd Consultant Pediatric Surgeon,
  • Mamoun Muhamed Rafea Consultant and Head of Department Pediatric Surgery,

DOI:

https://doi.org/10.46831/jpas.v1i2.70

Keywords:

Intussusception, Clinical presentation, Ultrasound, Hydrostatic reduction, Recurrence, complications, nil

Abstract

Background: Intussusception is one of the emergencies encountered in early childhood requiring emergent interventions. The purpose of the study is to determine the outcomes and prognosis of our methods and management strategies employed in children who developed intussusception.

Methods: This is a retrospective case series performed by reviewing the patient medical records, sonographic and radiological reports, and surgical notes of the patients managed for intussusception at our hospital from 2009–2018.

Results: A total of 355 cases of intussusception were managed during the study tenure. The etiology was idiopathic in 97.4% whereas the remaining patients had Meckel’s diverticulum, lymphoma, and intestinal polyp as pathological lead point (PLP). Ultrasound was used for the diagnosis as the primary investigation tool in all the patients, with 100% diagnostic accuracy in the current study. Non-operative management by hydrostatic reduction was performed successfully in 79.43% of the patients. Total episodes with recurrence were 23 (6%); 30% had recurrence within 48 hours. Recurrence occurred by an average of 7.68 months after the successful reduction.

Conclusions: The majority has idiopathic etiology, but secondary cause with some pathological lead point is also not uncommon. Profound attention is required for prompt identification and treatment to avoid bowel ischemia. Ultrasound remains the preferred diagnostic modality in our patients. Even with recurring episodes of intussusception, the primary treatment remains hydrostatic reduction. 

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Author Biographies

Wajeeh Uddin, Specialist Pediatric Surgeon

Latifa Women and Children Hospital, Dubai, United Arab

Vipul Gupta, Senior Specialist Pediatric Surgeon

Latifa Women and Children Hospital, Dubai, United Arab

Ghadeer Jabir, Consultant Pediatric Surgeon

Latifa Women and Children Hospital, Dubai, United Arab

Diary Abdulrahman Mohd, Consultant Pediatric Surgeon,

Latifa Women and Children Hospital, Dubai, United Arab

Mamoun Muhamed Rafea, Consultant and Head of Department Pediatric Surgery,

Latifa Women and Children Hospital, Dubai, United Arab

References

Lloyd DA, Kenny SE. The surgical abdomen. In: Pediatric gastrointestinal disease: Pathopsychological, diagnosis, management, 4th, Walker WA, Goulet O, Kleinman RE, et al (Eds), BC Decker, Ontario 2004. p.604.

Stringer MD, Pablot SM, Brereton RJ. Paediatric intussusception. Br J Surg. 1992; 19:867–76.

Ksia A, Mosbahi S, Brahim MB, Sahnoun L, Haggui B, Youssef SB, et al. Recurrent intussusception in children and infants. Afr J Paediatr Surg. 2013; 10:299-301.

Niramis R, Watanatittan S, Kruatrachue A, Anuntkosol M, Buranakitjaroen V, Rattanasuwan T, et al. Management of recurrent intussusception: Nonoperative or operative reduction? J Pediatric Surg. 2010; 45:2175-80.

Sargent MA, Babyn P, Alton GJ. Plain abdominal radiography in suspected intussusception: a reassessment. Pediatr Radiol. 1994; 24:17-20.

Hsiao HJ, Wang CJ, Lee CC, Hsin YC, Yau SY, Chen SY, et al. Point-of-care ultrasound may reduce misdiagnosis of pediatric intussusception. Front Pediatr. 2021; 9:601492.

Kobborg M, Knudsen K, Ifaoui I, Rasmussen L, Qvist N, Ellebæk M, et al. Early diagnosis and treatment for intussusception in children is mandatory. Danish Med J. 2021; 68:A09200680.

del-Pozo G, Albillos JC, Tejedor D. Intussusception in children: current concepts in diagnosis and enema reduction. Radiographics. 1999; 19:299-19.

DiFiore JW. Intussusception. Semin Pediatr Surg. 1999; 8:214–20.

Okuyama H, Nakai H, Okada A. Is barium reduction safe and effective in patients with a long duration of intussusception? Pediatr Surg Int. 1999; 15:105-7.

Sorantin E, Lindbichler F. Management of intussusception. Eur Radiol. 2004; 14:L146-L154.

Saxena AK, Höllwarth ME. Factors influencing management and comparison of outcomes in paediatric intussusceptions. Acta Paediatr. 2007; 96:1199-1202.

Champoux AN, Del Beccaro AM, Nazar-Stewart V. Recurrent intussusception: risks and features. Arch Pediatr Adolesc Med. 1994; 148:474-8.

Daneman A, Alton DJ, Lobo E, Gravett J, Kim P, Ein SH. Patterns of recurrence of intussusception in children: a 17-year review. Pediatr Radiol. 1998; 28:913-9.

Yang CM, Hsu HY, Ni YH, Lin FY, Chang MH. Recurrence of intussusception in childhood. Acta Paediatrica Sinica. 1999; 40:157-8.

Pierro A, Donnell SC, Paraskevopoulou C, Carty H, Lloyd DA. Indications for laparotomy after hydrostatic reduction for intussusception J Pediatr Surg. 1993; 28: 1154-7.

Blakelock RT, Beasley SW. The clinical implications of non-idiopathic intussusception. Pediatr Surg Int. 1998; 14:63-7.

Mandeville K, Chien M, Willyerd FA. Intussusception: clinical presentations and imaging characteristics. Pediatr Emerg Care. 2012; 28:842.

Buettcher M, Baer G, Bonhoeffer J, Schaad UB, Heininger U. Three-year surveillance of intussusception in children in Switzerland. Pediatr. 2007; 120:473.

John M, Siji CR. A clinical study of children with intussusception. Int J Contemp Pediatr. 2016; 3:1083-88.

Kumar K. Ultrasound-guided hydrostatic reduction in the management of intussusception. Indian J Pediatr. 2006; 73:217-21.

Weihmiller. Risk stratification of children being evaluated for intussusception. Pediatr. 2011; 127:296-303.

Khan J. Retrospective analysis of clinical presentation of children with diagnosed intussusception. JPM. 2007; 21:151-3.

Julie EB, Nguyen TL, Frances J, Tran NS, John BC, Margaret DC, et al. Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia. Bull World Health Organ. 2006; 84:1-11.

Klein EJ, Kapoor D, Shugerman RP. The diagnosis of intussusception. Clin Pediatr (Phila). 2004; 43:343-34.

Bailey KA, Wales PW, Gerstle JT. Laparoscopic versus open reduction of intussusception in children: a single-institution comparative experience. J Pediatr Surg. 2007; 42:845-8.

Navarro O, Daneman A. Intussusception. Part 3: Diagnosis and management of those with an identifiable or predisposing cause and those that reduce spontaneously. Pediatric Radiol. 2004; 34:305-12.

St-Vil, D, Brandt ML, Panic S. Bensaussant AL, Blanchard H. Meckel's diverticulum in children: a 20-year review. J Pediatr Surg. 1991; 26:1289- 92.

Hwang CS, Chu CC, Chen KC, Chen A. Duodenojejunal intussusception secondary to hamartomatous polyps of duodenum surrounding the ampulla of Vater. J Pediatr Surg. 2001; 36: 1073-5.

Chen Y, Ni YH, Chen CC. Neonatal intussusception due to a caecal duplication cyst. J Formos Med Assoc 2000; 99:352-3.

Hamada Y, Fukunaga S, Takada K, Sato M, Hioki K. Postoperative intussusception after incidental appendicectomy. Pediatr Surg Int. 2002; 18:284- 6.

Justice FA, Auldist AW, Bines JE. Intussusception: trends in clinical presentation and management. J Gastroenterol Hepatol. 2006; 21:842-6.

Bajaj L, Roback MG. Post reduction management of intussusception in a children’s Hospital Emergency Department. Pediatr. 2003; 112:1302-7.

Yalcin S. Presenting clinical features and outcome in intussusception. Indian J Pediatric. 2009; 76:401- 5.

Wei-Lun H, Hung-Chang L, Chun-Yan Y, Wai-Tao C, Chuen-Bin J, Jin-Cherng S, et al. Recurrent intussusception: When should surgical intervention be performed? Pediatr Neonatol. 2012; 53:300-3.

Published

2021-08-20

How to Cite

1.
Uddin W, Gupta V, Jabir G, Mohd DA, Rafea MM. Single-center experience of managing childhood intussusception. J Pediatr Adolesc Surg [Internet]. 2021Aug.20 [cited 2024Mar.29];1(2):84-8. Available from: https://jpedas.org/ojs/index.php/jpedas/article/view/jpas-70
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