Intussusception in older children.

Abstract

LiverpoolSUMMARY In a retrospective series of 37 cases of intussusception in children over 2 years of age, it was found that a subacute or chronic presentation was more common than in infancy, that few of them had rectal bleeding, and only a minority had a palpable intussusception. Diagnosis was often difficult but was helped by plain abdominal x-rays. Although the majority of children underwent surgery, with a 22% incidence of lead points, it is concluded that attempted hydrostatic reduction in these older children is not contraindicated, provided x-rays do not show small bowel obstruction.Intussusception mainly affects infants in whom it generally presents with a short history of colic, vomiting, and passage of blood per rectum, and the lesion is generally palpable abdominally or rectally. Rarely is an underlying anatomical cause found.1-5 Less than one-quarter of cases of intussusception are in children over age 2 years, but these older children have a less consistent mode of presentation, offer a greater diagnostic challenge, and are more likely to have an underlying cause.6-8 As such children had not hitherto been considered separately, we now review our experience of intussusception with them.

Is non-operative intussusception reduction effective in older children? Ten-year experience in a university affiliated medical center

“…Five patients had follow-up imaging as inpatients after the successful reduction, including UGI series [1], US [4] and abdominal CT [3], to exclude additional pathology or a lead point that could be missed by fluoroscopy. All these examinations were within normal limits.…”

“…In several publications, prolonged and relatively mild clinical course was often present in the older age group of children, as well as a higher recurrence rate [1,2,10,14]. Several papers and reviews concerning intussusception and methods of reduction were published recently, however none discuss age-related contraindications.…”

“…Ileo-colic or ileo-ileocolic intussusception in older children occurs due to a pathological lead point in up to 20-25% of the cases [1,2]. In the adult population intussuscepton is uncommon, and very rarely idiopathic.…”

Intussusception in Adults with Cystic Fibrosis: A Case Series with Review of the Literature

“…It is a relatively common cause of an acute abdomen in the first two years of life, but is uncommon in older children [1]. The diagnosis is rare in adult life, with presentations in adulthood comprising 5% of all intussusceptions and 1% of bowel obstructions [2].…”

Are Interleukin-6, Body Mass Index and Atopy Crucial in Infantile Intussusception?

“…A pathological lesion leading to IS is found in only 3% of cases under 1 year [5,[9][10][11]. Idiopathic IS is found more frequently in well-fed, plump infants [5,12].…”