Lethargy as an initial symptom of intussusception secondary to Meckel's diverticulum in a 2.5 year-old girl: Case report

Badour, Maysaa; Hammed, Ali; Baqla, Sameer

doi:10.1016/j.amsu.2021.102562

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…The clinical manifestations of intussusception in children are varied and non-specific ( 11 – 13 ). The classic triad of pediatric intussusception includes vomiting, intermittent abdominal pain, and bloody currant jelly stool; however, this occurs in fewer than half of affected patients ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of pediatric intussusception and predictors of bowel resection in affected patients

Huang

et al. 2022

Front. Surg.

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BackgroundSurgery is required for the treatment of intussusception when enema reduction is unsuccessful, or when the patient develops peritonitis, bowel perforation, or intestinal damage. We aimed to evaluate the clinical and laboratory parameters that may be used to predict the need for bowel resection in children with intussusception.MethodsThis observational retrospective study included children who were admitted to the pediatric emergency department with intussusception. Univariate and multivariate logistic regression models were used to evaluate factors associated with bowel resection.ResultsIn total, 584 children with intussusception were admitted to the pediatric emergency department; 129 of these children underwent surgery. Multivariate analysis revealed the following independent predictors of bowel resection for intussusception: symptoms for at least 2 days before surgery (OR = 6.863; p = 0.009), long intussusception (OR = 5.088; p = 0.014), pathological lead point (OR = 6.926; p = 0.003), and intensive care unit admission (OR = 11.777; p = 0.001) were factors independently associated with bowel resection.ConclusionSymptoms for at least 2 days before surgery, long intussusception, pathological lead, and intensive care unit admission were predictors of bowel resection in children with intussusception. These findings can be used to identify patients at high risk of needing surgery and bowel resection.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics of pediatric intussusception and predictors of bowel resection in affected patients

Huang

et al. 2022

Front. Surg.

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“…Although in the literature, children up to 10 years of age represent more than 50% of symptomatic MD cases, ( 3 ) the incidence in the reports reviewed in this discussion proved to be slightly different. Two patients were less than 6 months of age, ( 6 , 10 ) three between 1 and 6 years of age, ( 14 , 16 , 17 ) five between 15 and 30 years of age ( 5 , 7 , 13 , 18 , 19 ) and five between 40 and 50 years of age. ( 8 , 9 , 11 , 12 , 15 )…”

Section: Discussionmentioning

confidence: 99%

“…From a geographical perspective, we observed that 15 publications came from five continents. One was from America (United States), (5) four from Europe (Italy, (6) France, (7) Spain (8) and the United Kingdom), (9) one from Africa (Tunisia), (10) seven from Asia (Japan, (11)(12)(13)(14) South Korea, (15) China (16) and Syria) (17) and two from Oceania (Australia). (18,19) Regarding the age of the patients included in this sample, there was a range from newborns to 49 years of age.…”

Section: Epidemiologymentioning

confidence: 99%

Intestinal intussusception of Meckel’s diverticulum, a case report and literature review of the last five years

Schaedlich¹,

Borges²,

Lacombe³

et al. 2023

Einstein (São Paulo)

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Meckel’s diverticulum is the most common gastrointestinal tract anomaly. It arises from the incomplete closure of the omphalomesenteric conduit, which is a true diverticulum at the antimesenteric border of the ileum. Although the majority of patients are asymptomatic, they can present with inflammation, hemorrhage, intussusception, intestinal obstruction, and perforation, among others; this constitutes an important differential diagnosis for acute abdomen. A 19-year-old female sought medical attention because of intermittent diffuse abdominal pain for two months, nausea, and diarrhea. In the requested imaging tests, tomography, and enterotomography, a diagnosis of Meckel’s diverticulum with some degree of intussusception was suggested. The patient underwent elective surgical treatment without complications and was discharged on the second postoperative day with clinical improvement. In this section, we review publications on similar cases published in the last five years.

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“…In general, most intussusceptions can be categorized as primary or idiopathic, with thickened bowel wall lymphoid tissue (Peyer patches) acting as the lead point. Approximately 5–12% of intussusceptions are pathological, which usually present with different symptoms and are caused by conditions such as Meckel’s diverticula ( 4 ), intestinal polyps ( 5 , 6 ), intestinal duplication ( 7 ), allergic purpura ( 8 ) and some rare digestive tract malignant tumors ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for Predicting Pathological Intussusceptions in Children Prior to Surgical Intervention

Duan

Liu

et al. 2022

Front. Pediatr.

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PurposeEstablish and validate a nomogram to help predict the preoperative risk of a pathological intussusception.MethodsA primary cohort of patients who underwent surgery for an intussusception were enrolled from one center, while a validation cohort consisted of patients from another center. Multivariate logistic regression analysis was used to identify the variables to build the nomogram. A calibration curve accompanied by the Hosmer-Lemeshow test was used to assess the calibration of the nomogram. To quantify the discrimination of the nomogram, Harrell’s C-index was calculated. The performance of the validated nomogram was tested in the external validation cohort. The logistic regression formulae created during the analysis of the primary cohort was applied to all patients in the external validation cohort, and the total points for each patient were calculated.ResultsThe primary cohort consisted of 368 patients and the validation cohort included 74. The LASSO logistic algorithm identified three (recurrence episodes, mass size, and infection history) out of 11 potential clinical variables as significantly predictive of a pathologic intussusception. The C-index for the predictive nomogram was 0.922 (95% CI, 0.885–0.959) for the primary cohort and 0.886 (95% CI, 0.809–0.962) for the validation cohort. The decision curve showed that if the threshold probability of a patient in the validation cohort was > 7%, then the nomogram was more beneficial than either indiscriminately treating all or none of the patients.ConclusionWe developed a nomogram based on clinical risk factors that could be used to individually predict pathological intussusceptions in children prior to surgical intervention.

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Lethargy as an initial symptom of intussusception secondary to Meckel's diverticulum in a 2.5 year-old girl: Case report

Cited by 4 publications

References 16 publications

Clinical characteristics of pediatric intussusception and predictors of bowel resection in affected patients

Clinical characteristics of pediatric intussusception and predictors of bowel resection in affected patients

Intestinal intussusception of Meckel’s diverticulum, a case report and literature review of the last five years

Development and Validation of a Nomogram for Predicting Pathological Intussusceptions in Children Prior to Surgical Intervention

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