Management and Outcome of Pediatric Patients With Transient Small Bowel–Small Bowel Intussusception

Melvin, Jennifer E.; Zuckerbraun, Noel S.; Nworgu, Chijindu R; Mollen, Kevin P.; Furtado, Andre D.; Manole, Mioara D.

doi:10.1097/pec.0000000000001503

Cited by 13 publications

(15 citation statements)

References 13 publications

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“…These two mechanisms may also explain the fact that in our study some children complained of the pain when TEI was present, while some did not. The same finding was noted and reported by other authors [9].…”

Section: Discussionsupporting

confidence: 92%

Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Plut

2020

Srp Arh Celok Lek

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Introduction/Objective. Recurrent colic abdominal pain (RCAP) is a common complaint in children. Children with this complaint are often referred to abdominal ultrasound (US). Examining the children with RCAP by US in our outpatient clinic we occasionally noticed transient enteroenteric intussusceptions (TEIs) with spontaneous resolution. The objectives of our prospective observational study were to determine the prevalence and evaluate the significance of TEIs in children with RCAP. Methods. From January 2016 to December 2017 we examined 358 children with RCAP by US. Age range was 1?17 years (mean age 7.7 years). TEIs were detected and the prevalence determined. The sensation of pain at the time of the US examination was noted. Results. We detected TEI in 41 children; the prevalence was 11.5%. Abdominal pain at the time of the presence of TEI was reported in 17.1% of these children. In the group of children without TEI detected, pain at the time of the examination was reported in only 6%. A statistically significant relationship was found between the presence of TEI and the pain at the time of the examination (p = 0.046). No child had other significant abdominal pathology. Conclusion. TEIs happen more commonly in children than previously thought. A rather high prevalence of TEIs in our study group of children with RCAP and the fact that higher percentage of children with detected TEI experienced pain at the time of the examination, are suggestive that TEIs may be one of the causes for the RCAP in children.

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Section: Discussionsupporting

confidence: 92%

Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Plut

2020

Srp Arh Celok Lek

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“…Consistent with recommendations from the American Pediatric Surgical Association [ 101 ], we found only a few children who received prophylactic antibiotics prior to or during nonoperative reduction, as there is no evidence that this practice is beneficial, likely because bacteremia and perforation are rare, except for in children with hemodynamic instability or critical illness [ 101 ]. Few of the ISN cases that had an ileo-ileal type were managed without nonoperative reduction, because the involvement of small bowel ISN is less likely to respond to pneumatic or hydrostatic reduction and more likely to reduce spontaneously (follow-up and bowel rest) [ 102 ].…”

Section: Discussionmentioning

confidence: 99%

Intussusception and COVID-19 in Children: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Intussusception (ISN) post-COVID-19 infection in children is rare but can occur. SARS-CoV-2 may play a role in the pathogenesis of ISN and trigger immune activation and mesenteric adenitis, which predispose peristaltic activity to “telescope” a proximal bowel segment into the distal bowel lumen. Objectives: To estimate the prevalence of SARS-CoV-2 infection in ISN children and analyze the demographic parameters, clinical characteristics and treatment outcomes in ISN pediatric patients with COVID-19 illness. Methods: We performed this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies reporting on the incidence of ISN post-SARS-CoV-2 infection in children, published from 1 December 2019 until 1 October 2022, in PROQUEST, MEDLINE, EMBASE, PUBMED, CINAHL, WILEY ONLINE LIBRARY, SCOPUS and NATURE, with a restriction to articles available in the English language, were included. Results: Of the 169 papers that were identified, 34 articles were included in the systematic review and meta-analysis (28 case report, 5 cohort and 1 case-series studies). Studies involving 64 ISN patients with confirmed COVID-19 (all patients were children) were analyzed. The overall pooled proportions of the ISN patients who had PCR-confirmed SARS-CoV-2 infection was 0.06% (95% CI 0.03 to 0.09, n = 1790, four studies, I2 0%, p = 0.64), while 0.07% (95% CI 0.03 to 0.12, n = 1552, three studies, I2 0%, p = 0.47) had success to ISN pneumatic, hydrostatic and surgical reduction treatment and 0.04% (95% CI 0.00 to 0.09, n = 923, two studies, I2 0%, p = 0.97) had failure to ISN pneumatic, hydrostatic and surgical reduction treatment. The median patient age ranged from 1 to 132 months across studies, and most of the patients were in the 1–12 month age group (n = 32, 50%), p = 0.001. The majority of the patients were male (n = 41, 64.1%, p = 0.000) and belonged to White (Caucasian) (n = 25, 39.1%), Hispanic (n = 13, 20.3%) and Asian (n = 5, 7.8%) ethnicity, p = 0.000. The reported ISN classifications by location were mostly ileocolic (n = 35, 54.7%), and few children experienced ileo-ileal ISN (n = 4, 6.2%), p = 0.001. The most common symptoms from ISN were vomiting (n = 36, 56.2%), abdominal pain (n = 29, 45.3%), red currant jelly stools (n = 25, 39.1%) and blood in stool (n = 15, 23.4%). Half of the patients never had any medical comorbidities (n = 32, 50%), p = 0.036. The approaches and treatments commonly used to manage ISN included surgical reduction of the ISN (n = 17, 26.6%), pneumatic reduction of the ISN (n = 13, 20.2%), antibiotics (n = 12, 18.7%), hydrostatic reduction of the ISN (n = 11, 17.2%), laparotomy (n = 10, 15.6%), intravenous fluids (n = 8, 12.5%) and surgical resection (n = 5, 7.8%), p = 0.051. ISN was recurrent in two cases only (n = 2, 3.1%). The patients experienced failure to pneumatic (n = 7, 10.9%), hydrostatic (n = 6, 9.4%) and surgical (n = 1, 1.5%) ISN treatment, p = 0.002. The odds ratios of death were significantly higher in patients with a female gender (OR 1.13, 95% CI 0.31–0.79, p = 0.045), Asian ethnicity (OR 0.38, 95% CI 0.28–0.48, p < 0.001), failure to pneumatic or surgical ISN reduction treatment (OR 0.11, 95% CI 0.05–0.21, p = 0.036), admission to ICU (OR 0.71, 95% CI 0.83–1.18, p = 0.03), intubation and placement of mechanical ventilation (OR 0.68, 95% CI 0.51–1.41, p = 0.01) or suffering from ARDS (OR 0.88, 95% CI 0.93–1.88, p = 0.01) compared to those who survived. Conclusion: Children with SARS-CoV-2 infection are at low risk to develop ISN. A female gender, Asian ethnicity, failure to ISN reduction treatment (pneumatic or surgical), admission to ICU, mechanical ventilation and suffering from ARDS were significantly associated with death following ISN in pediatric COVID-19 patients.

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“…In addition, there would be a continuous and effective care relationship with the patient in the plan that fully conform to his/her characteristics and severity of the problems. 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

Follow-up Plan as a Necessity for Nursing Care: A Decrease of Stress in Mothers with their Children in Pediatric Surgical Units

2021

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Introduction: Children are vulnerable to damage. Health problems in children, especially ifnecessitate hospitalization, can cause stress in their parents that may persist even long afterdischarge. This study aimed to investigate the effect of implementing follow-up care plans onstress in mothers of children discharged from pediatric surgical units. Methods: A quasi-experimental study was conducted on 64 mothers whose children were hospitalized in the surgical wards of two educational hospitals affiliated to Isfahan Universityof Medical Sciences, Iran. The participants were randomly assigned into two groups of controland experimental. The data collection tools included a demographic data questionnaire andstress response inventory (SRI). The interventions were performed using a four-stage follow-upcare plan. The data were analyzed using SPSS software version 13 and descriptive statistics, independent t-test, repeated measures analysis of variance (ANOVA), and least significant difference (LSD) test. Results: The mean (SD) stress scores of the experimental group were 64.1 (28.8), 20.4 (12.4),and 11.6 (7.5) before, one week, and one month after the intervention, respectively. In the control group, these scores were 61.2 (29.2), 59.9 (25.5), and 46.7 (19.1), respectively. The results showed the mean score was significantly lower than that of the control group at oneweek and one month after the intervention in the experimental group. Conclusion: Our results demonstrated that a follow-up care plan can decrease the stress levelsof mothers as a continuity of patient care even after discharge.

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Management and Outcome of Pediatric Patients With Transient Small Bowel–Small Bowel Intussusception

Cited by 13 publications

References 13 publications

Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Intussusception and COVID-19 in Children: A Systematic Review and Meta-Analysis

Follow-up Plan as a Necessity for Nursing Care: A Decrease of Stress in Mothers with their Children in Pediatric Surgical Units

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