Intussusception : Experience in 507 Thai Pediatric Patients

Authors

  • Rangsan Niramis Department of Surgery, Queen Sirikit National Institute of Child Health (Children's Hospital), Bangkok 10400, Thailand.
  • Sukawat Watanatittan Department of Surgery, Queen Sirikit National Institute of Child Health (Children's Hospital), Bangkok 10400, Thailand.
  • Maitree Anuntkosol Department of Surgery, Queen Sirikit National Institute of Child Health (Children's Hospital), Bangkok 10400, Thailand.
  • Tongkao Rattanasuwan Department of Surgery, Queen Sirikit National Institute of Child Health (Children's Hospital), Bangkok 10400, Thailand.

Abstract

Background Purpose: Intussusception remains an important cause of intestinal obstruction in children under the age of 2 years. Management of this disease has continuously improved with better outcomes. This study aims to review our experience in patients with intussusception at a referral center for children in Thailand.

Methods: Medical records of patients treated from January 1, 1988 to December 31, 1998 for intussusception at the Queen Sirikit National Institute of Child Health were reviewed. Information about clinical manifestations, radiological findings and results of treatment were obtained. The statistical differences were analyzed by the Chi-square and the Z-test.

Results: Five-hundred and seven patients with 549 episodes of intussusception were available for the review. Two-hundred and eighty-eight (56.8%) were male and 219 (43.2%) were female. About 80 percent of patients were under one year of age with the peak incidence at 6 months. The disease was found in every month with the highest incidence between January to March. Vomiting was the most common symptom, being found in 90 percent of the patients. Bloody stool, abdominal pain and palpable abdominal mass were found in 75, 72 and 57 percent respectively. Radiological findings revealed complete intestinal obstruction and soft tissue mass in 65 and 32 percent of the cases.

               Hydrostatic barium enema (BE) reduction was attempted in 211 episodes and found to be successful in 135 (64 %) with a colonic perforation in 3 cases. Pneumatic reduction was attempted in 243 episodes and found to be successful in 178 (73 %). Surgical treatment was needed in 234 episodes. Of these, manual reduction was successful in 158, intestinal resection was required in 68. Appendectomy only was done in the remaining 8 patients because complete reduction was noted during exploration. Leading points were recorded in 20 patients (3.9 %). Meckel's diverticulum (8 cases) and intestinal polyp (5 cases) were the most common causes. The overall mortality rate was 0.8 percent (4 cases) and all the deaths occurred after intestinal resection due to bowel necrosis and septicemia.

Conclusion: Treatment outcomes of intussusception have continuously been improved. Non-operative reduction should be the initial management, unless the patients had contraindications for such intervention, because it has the lowest incidences of morbidity and mortality.

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References

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Published

2001-12-28

How to Cite

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Niramis R, Watanatittan S, Anuntkosol M, Rattanasuwan T. Intussusception : Experience in 507 Thai Pediatric Patients. Thai J Surg [Internet]. 2001 Dec. 28 [cited 2022 Oct. 1];22(4):123-30. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/243140

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