Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong

Abstract

Objectives:To review all paediatric patients with intussusception over the last 17 years. Design: Retrospective case series.Setting: A tertiary centre in Hong Kong. Patients:Children who presented with intussusception from January 1997 to December 2014 were reviewed. Main outcome measures:The duration of symptoms, successful treatment modalities, complication rate, and length of hospital stay were studied.Results: A total of 173 children (108 male, 65 female) presented to our hospital with intussusception during the study period. Their median age at presentation was 12.5 months (range, 2 months to 16 years) and the mean duration of symptoms was 2.3 (standard deviation, 1.8) days. Vomiting was the most common symptom (76.3%) followed by abdominal pain (46.2%), per rectal bleeding or red currant jelly stool (40.5%), and a palpable abdominal mass (39.3%). Overall, 160 patients proceeded to pneumatic or hydrostatic reduction, among whom 127 (79.4%) were successful. Three (1.9%) patients had bowel perforation during the procedure. Early recurrence of intussusception occurred in four (3.1%) patients with non-operative reduction. No

Pneumatic Reduction of Paediatric Intussusception: Clinical Experience and Factors Affecting Outcome

“…This was probably due to increased experience with improved technique and equipment, and may also account for the high success rate of 88% in 2013 ( Table 2). Our reduction rate was comparable with the 77.2% reduction rate achieved in a similar local case series, 16 and comparable with the rates achieved in the international literature published from North America, 3,4 China, 13 and Japan 12 ; it was also considerably higher than the recently published national reduction rate of only 71% achieved in the United Kingdom. 17 In this study, the success rate was higher in children over the age of 1 year (89.1%) compared with children under 1 year (81.3%), but the difference did not reach statistical significance in this study.…”

Systematic review shows that pathological lead points are important and frequent in intussusception and are not limited to infants

“…The presence of pathological lead points reportedly ranges from as low as 0.33% , 3% , 5% , 5% , 6% , 8.5% , 15% and up to 20% . These differences are easy to explain because the study designs varied from epidemiological approaches to large single centre series.…”

A rare association of intussusception and celiac disease in a child

“…[1][2][3][4] It is the most common cause of intestinal obstruction at pediatric ages and needs prompt intervention, which may be surgical or nonsurgical.…”

“…Invagination of the proximal bowel into the distal bowel results in venous congestion and bowel wall edema. 1 If not promptly diagnosed and treated, this condition can lead to arterial obstruction, bowel necrosis and perforation. Almost 90% of the etiology of intussusception in children is ileocolic and idiopathic.…”

“…Almost 90% of the etiology of intussusception in children is ileocolic and idiopathic. 1 The lead point of the invagination is lymphoid hyperplasia of the small bowel, but Meckel's diverticulum, polyps and trauma can also lead to this problem.…”