Childhood Intussusception: A Study of 55 Cases

Hanoudi, Basil

	Childhood Intussusception: A Study of 55 Cases
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 25, Issue 1, 2012, Pages 32-39
Author
Basil Hanoudi
Abstract
Background: Intussusception occurs when a portion of the alimentary tract is telescoped into an adjacent segment. It is the most common cause of intestinal obstruction between 3months and 6years of age. The majority of cases in children are idiopathic. Objective: To study the importance of different presenting clinical signs and symptoms, outcome, and to evaluate the efficacy of imaging procedures in diagnosis. Methods: Prospective study of patients aged (4-48months) with signs and symptoms consistent with intussusception were studied during the period from the 1st of Feb. to the 31st of July 2009. History was taken including; name, sex, age, duration of illness, clinical manifestation, examination, erect plain abdominal X-ray and abdominal ultrasound and CT scan of abdomen was done in selected cases. Data were collected to evaluate abdominal X-ray, ultrasound and CT scan as guidance for diagnosis of intussusceptions in children. All patients were treated by surgical reduction and notes were taken regarding type of intussusceptions and the presence of underlying pathology. Results: Fifty five patients were studied; their mean age was of 12±3 months. Males were more than females with a male:female ratio of 1.6:1. Most of patients presented with vomiting, blood in stool and abdominal pain. Pain, fever, constipation, diarrhea and intestinal prolapse through anus were less frequent presentations of the study group. During examination an abdominal mass was found in 63.6% of cases, while current jelly by per-rectal examination was found in 38.2%. We found that most common sign detected by abdominal ultrasound was the presence of abdominal mass (67.3%), further more ultrasound can be used to detect peritonitis and detect the presence of underlying pathology. X-ray was also helpful in making diagnosis, while CT scan was used in 2 cases suspected to have lymphoma. Surgical reduction was done to all cases. Six of cases had bowel ischemia who were presented after 48 hours. Conclusion: Intussusceptions is more common in boys than in girls. Vomiting, bleeding in stool and abdominal pain were the commonest presenting symptoms and the characteristic abdominal mass and red current jelly stool is not always present. X-ray, ultrasound of abdomen are useful methods in the diagnosis, while CT scan which is highly sensitive is not routinely used

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