PEDIATRIC INTUSSUSCEPTION: DIAGNOSIS, SURGICAL TREATMENT, AND LONG-TERM PROGNOSIS
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Keywords
Intussusception, Pediatrics surgery, Diagnosis, Treatment
Abstract
Background: Intussusception is a common paediatric emergency involving the invagination of one part of the intestine into the adjacent one with consequent obstruction. It mainly occurs in children who are between six months and three years of their age. Bowel necrosis and perforation can occur and these imply the need for early diagnosis and treatment. Diagnostic accuracy, treatment outcomes and long-term prognosis are appraisal in this work.
Objective: This study was aimed to assess the diagnostic findings together with the therapeutic effectiveness of intussusception in paediatric patients and the long term outcome of this condition.
Methods: A prospective observational study was conducted for about 4 months from July, 2011 to Oct, 2011 in the Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan. A total of 150 pediatric intussusception patients were reviewed in this study. Symptoms, radiological appearances, management and prognosis were examined. Therapies used were ultrasound and air enema. These treatment options were as follows: conservative management, reduction without operation to internal fixation and operative management. Descriptive statistics used were standard deviation for variability and p-value for the significance of the results at p < 0.05 significance level.
Results: Out of 150 patients, 61 percent were male; the mean age of disease onset was 2.4 ± 0.7 years. Air enema was effective in 75% of cases however in 25% immediate surgical intervention was needed for reduction. We noted complications in 10 patients (6.7%). The mean hospital stay was 2·8 ± 1·2 days. Timing of presentation was confirmed to be significantly related to treatment success (x = 5.56; df = 1; p = 0.01).
Conclusions: Prompt diagnosis and management are critical factors that determine overall survival of children affected with intussusception. In majority cases, the procedure involves manipulation and immobilization which is more effective other than surgery but this is crucial for complex cases. Mitigation is possible with immediate medical intervention and it has a good long-term outcome.
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Muhammad Jehangir Khan
Associate Professor, Department of Paediatric Surgery, Khalifa Gulnawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan.