Etiological factors of Intussusception among children in a tertiary care hospital

Rahman, Mizanur; Islam, Tarikul; Rahman, Hamudur; Ahmed, Masud

doi:10.3329/bmjk.v49i1-2.31821

Cited by 2 publications

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“…The pathogenesis of intussusception is complicated and controversial [2]. It has been reported [4,5,6,7,8] that hyperplasia of submucosal lymphoid tissue in ileocecal region, especially the distalileum, may be closely related to the occurrence of primary intussusception in children, and may be the main cause. Most of them are reported from individual cases or from excised ileocecal specimens.…”

Section: Discussionmentioning

confidence: 99%

“…The hyperplasia of lymph nodes in the mesentery of the right lower abdomen is more likely to re ect the hyperplasia of submucosal lymphoid tissue in the ileocecal terminal ileum. According to literature [4,5,6,7,8], primary intussusceptions in children is closely related to mesenteric lymph node enlargement, and lymphoid hyperplasia of intestinal wall, especially submucosal lymphoid hyperplasia of terminal ileum, Since it is di cult to detect hyperplasia of submucosal lymphoid tissue at the terminal ileum by current non-invasive detection methods, most cases are from case reports or excised ileocecal specimens, which results in the lack of systematic studies on this theory. Moreover, most articles have not clari ed the correlation between the two parts of lymphoid tissue in the pathogenesis of primary intussusceptions in children.…”

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confidence: 99%

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The regularity of intestinal related lymphoid hyperplasia in children and its correlation with intussusception in children

Yan

Chao

et al. 2022

Preprint

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Background: Primary intussusception in children is a common acute abdominal disease. The cause of this disease is still not fully understood. Many literatures have reported that children with intussusception are often accompanied by hyperplasia of mesenteric lymph nodes and submucosal lymphoid tissue of the terminal ileum. Therefore, hyperplasia of intestinal associated lymphoid tissue (mesenteric lymph nodes and submucosal lymphoid tissue of the intestinal tract) may be one of the main causes of intussusception. However, the changing characteristics and differences of intestinal associated lymphoid tissues in healthy children and children with intussusception at different ages have not been reported. In addition, the relationship between mesenteric lymph nodes and intestinal submucosal lymphatic tissue also needs to be further understood. Methods: 73 patients with intussusception during recovery phase who were treated in our hospital from October 2019 to October 2021 were collected as the observation group, while 101 children with healthy physical examination or diseases unrelated to intestinal lymphoid hyperplasia were collected as the control group. They were divided into different age groups of 1-6 months, 7-12 months, 13-18 months, 19-24 months, 25-36 months, 3-4 years, 5-6 years, and 7-8 years old. Ultrasonography was used to perform exploration and scanning of mesenteric lymph nodes in fixed areas of the right lower abdomen and around the umbilicus. The size (cm3) and number (n) of detectable lymph nodes in each region were recorded and calculated, and the total mesenteric lymph node volume （cm3） of right lower abdomen（RLTMLNV） and periumbilical region （PTMLNV） was calculated respectively. The total mesenteric lymph node volume of each region in different ages of the two groups was analyzed.Result: 1.There were significant differences between the control group and the observation group in the right lower abdominal total mesenteric lymph nodes volume （RLTMLNV） and the periumbilical total mesenteric lymph nodes volume（PTMLNV）(P=0.001). The mesenteric lymph nodes in the observation group showed severe hyperplasia. 2. Children with intussusceptions are usually accompanied by severe mesenteric lymphoid hyperplasia. The mean volume of RLTMLNV was greater than that of PTMLNV. Especially within 2 years of age, the mean volume of RLTMLNV was significantly higher than that of PTMLNV with statistical significance (P<0.05). RLTMLNV has a better predictability of intussusception than PTMLNV, The occurrence of intussusception was more closely related to the hyperplasia of intestinal associated lymphoid tissue in the right lower abdomen. 3. In normal children (control group), lymph nodes in right lower abdomen and periumbilical mesentery showed low hyperplasia, and there was a significant difference between age groups of <2 years old and 2-8 years old (p =0.001). In the children with intussusception (observation group), the hyperplasia of mesenteric lymph nodes in the right lower abdomen and around the umbilicus was in the state of severe hyperplasia. There was no significant difference in the proliferation of mesenteric lymphoid tissue among different age groups in the right lower abdomen (P=0.834). and there was also no significant difference in hyperplasia of periumbilical mesenteric lymphoid tissue among different age groups (P=0.097).Conclusion: 1.The occurrence of primary intussusception in children is related to the hyperplasia of intestinal associated lymphoid tissue. 2. Children with intussusceptions were usually accompanied by severe mesenteric lymphoid hyperplasia. The mesenteric lymphoid hyperplasia was more obvious in the right lower abdominal ileocecal area than in the periumbilical area before 2 years of age. RLTMLNV has a better predictability of intussusception than PTMLNV, The occurrence of intussusceptions was more closely related to the hyperplasia of intestinal associated lymphoid tissue in the right lower abdomen. 3. Normal children showed low degree of mesenteric lymphoid hyperplasia before 2 years old, and moderate hyperplasia after 2 years old, and the degree of mesenteric lymphoid hyperplasia in right lower abdominal ileocecal area was basically the same as periumbilical mesenteric lymphoid hyperplasia. The lymphatic tissue of the right lower abdomen and periumbilical mesentery in children with intussusceptions showed severe hyperplasia, and there were no significant differences among different age groups. Fund program: Weifang Science and Technology Development Plan Project(2019YX007).; National Natural Science Foundation of China（82070856）

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The regularity of intestinal related lymphoid hyperplasia in children and its correlation with intussusception in children

Yan

Chao

et al. 2022

Preprint

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“…The hyperplasia of lymph nodes in the mesentery of the right lower abdomen is more likely to reflect the hyperplasia of submucosal lymphoid tissue in the ileocecal terminal ileum. According to articles [5][6][7][8][9], primary intussusceptions in children are closely related to mesenteric lymph node enlargement and lymphoid hyperplasia of the intestinal wall, especially submucosal lymphoid hyperplasia of the terminal ileum. Since it is challenging to detect hyperplasia of submucosal lymphoid tissue at the terminal ileum by current non-invasive detection methods, most cases are from case reports or excised ileocecal specimens, thus resulting in the lack of systematic studies on this theory.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of intestinal-related lymphoid hyperplasia in children and its correlation with intussusception of children

Yan

Chen

et al. 2022

BMC Pediatr

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Background Primary intussusception in children is a common acute abdominal disease. The cause of this disease is still not fully understood. Many articles have reported that children with intussusception are often accompanied by hyperplasia of mesenteric lymph nodes and submucosal lymphoid tissue of the terminal ileum. Therefore, hyperplasia of intestinal-associated lymphoid tissue (mesenteric lymph nodes and submucosal lymphoid tissue of the intestinal tract) may be one of the main causes of intussusception. However, the characteristics and differences of intestinal-associated lymphoid tissues in healthy children and children with intussusception at different ages have not been reported. In addition, the relationship between mesenteric lymph nodes and intestinal submucosal lymphatic tissue also needs to be further understood. Methods 73 patients with intussusception during the recovery phase who were treated in our hospital from October 2019 to October 2021 were collected as the observation group, while 101 children with healthy physical examination or diseases unrelated to intestinal lymphoid hyperplasia were collected as the control group. They were divided into different age groups of 1–6 months, 7–12 months, 13–18 months, 19–24 months, 25–36 months, 3–4 years, 5–6 years, and 7–8 years old. Ultrasonography was used to explore and scan mesenteric lymph nodes in fixed areas of the right lower abdomen and around the umbilicus. The size (cm3) and number (n) of detectable lymph nodes in each region were recorded and calculated, and the total mesenteric lymph node volume (cm3) of the right lower abdomen (RLTMLNV) and periumbilical region (PTMLNV) was calculated, respectively. The total mesenteric lymph node volume of each region in different ages of the two groups was analyzed. Results (1) There were significant differences between the control group and the observation group in the right lower abdominal total mesenteric lymph nodes volume (RLTMLNV) and the periumbilical total mesenteric lymph nodes volume (PTMLNV) (P = 0.001). The mesenteric lymph nodes in the observation group showed severe hyperplasia. (2) Children with intussusceptions are usually accompanied by severe mesenteric lymphoid hyperplasia. The mean volume value of RLTMLNV was greater than that of PTMLNV. Especially within 2 years of age, the mean value of RLTMLNV was significantly higher than that of PTMLNV with statistical significance (P < 0.05). (3) In normal children (control group), lymph nodes in the right lower abdomen and periumbilical area showed low hyperplasia, and there was a significant difference between age groups of < 2 years old and 2–8 years old (p = 0.001). In the children with intussusception (observation group), the hyperplasia of mesenteric lymph nodes in the right lower abdomen and around the umbilicus was severe. There was no significant difference in the proliferation of mesenteric lymphoid tissue among different age groups in the right lower abdomen (P = 0.834). There was also no significant difference in hyperplasia of periumbilical mesenteric lymphoid tissue among different age groups (P = 0.097). Conclusions Our research shows: (1) The occurrence of primary intussusception in children is related to the hyperplasia of intestinal-associated lymphoid tissue. (2) Children with intussusceptions were usually accompanied by severe mesenteric lymphoid hyperplasia. The mesenteric lymphoid hyperplasia was more evident in the right lower abdominal ileocecal area than in the periumbilical area before 2 years of age. RLTMLNV has better predictability of intussusception than PTMLNV. The occurrence of intussusceptions was more closely related to the hyperplasia of intestinal-associated lymphoid tissue in the right lower abdomen. (3) Normal children showed a low degree of mesenteric lymphoid hyperplasia before 2 years old, moderate hyperplasia after 2 years old, and mesenteric lymphoid hyperplasia in the right lower abdominal ileocecal area was basically the same as the periumbilical area. The lymphatic tissue of the right lower abdomen and periumbilical mesentery in children with intussusceptions showed severe hyperplasia, and there were no significant differences among different age groups.

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Etiological factors of Intussusception among children in a tertiary care hospital

Abstract: Background: There are still dearth of knowlege of intussusception regarding its aetiology and predisposing factor among children.

Cited by 2 publications

References 3 publications

The regularity of intestinal related lymphoid hyperplasia in children and its correlation with intussusception in children

The regularity of intestinal related lymphoid hyperplasia in children and its correlation with intussusception in children

Characteristics of intestinal-related lymphoid hyperplasia in children and its correlation with intussusception of children

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