Intussusception In Infancy and Childhood at Surin Hospital

Abstract

Background: Intussusception in pediatric patient is the most common cause of emergency surgery in early infant. And without immediate intervention, severe complications such bowel necrosis and perforation may cause of sepsis and death.
Objective: To study symptoms and admitting diagnosis, treatment and outcome including complications of pediatric intussusception patients at Surin hospital.
Setting: Surin hospital
Study design: Descriptive retrospective study
Method: Review of pediatric patients (aged under 15 years) data admitted with intussusception during 1st October to 30th September 2008
Result: There were 32 pediatric patients aged under 15 years diagnosed with intussusception. The male to female ratio is 1.7:1 (male 20 patients and female 12 patients). Patients aged from two months to six years which 27 patients (81.25%) aged below (me year. The cases were mostly found during January to May and in November. Clinical symptoms which leaded to hospital were vomiting 26 cases (81.25%) and currant bloody (mucoid and bloody) stool 22 cases (68.75%) while abdominal pain were only found in 4 cases (12.50%). There were 8 patients (25%) presented with all three major (symptom triad) symptoms of vomiting, currant bloody stool and abdominal pain. Physical examination found flatulence in 24 patients (75.0%) and rectal examination found currant blood in 14 patients (77.78%) from overall 18 patients. Palpable abdominal mass only found in 9 patients (28.12%) from 32 patients. There were two patients presented with symptom triad found palpable abdominal mass (6.25%). Admitting diagnosis of these patients were Intussusception 21 patients (65.62%) and gut obstruction 4 patients (12.50%). Non operative reduction by Hydrostatic Barium Enema was success in 5 cases (29.41%) from 17 cases and there was no mortality found in this study.
Conclusion: Pediatric intussusception has three major symptoms of vomiting, currant bloody stool and abdominal pain or crying in infant. Therefore physician should also consider intussusception for differential diagnosis in pediatric patients who presented with at least one of these symptom triad. These will benefit for early diagnosis and immediate treatment to decrease operation and its complications.