Acute intestinal intussusception of the infant and the child: A 5-year study of 66 cases

Abstract

Background: Acute intestinal intussusception (AII) is defined as the telescoping of part of the intestine into the intestinal segment beneath it. The consequence is an obstruction and strangulation which can lead to necrosis of the intestinal tract that has telescoped. The aim of our work is, on the one hand, to assess our management style throughout analysis of clinical different aspects and on the other hand to set up a strategy for early diagnosis and treatment. Methods: It is a retrospective study over 5 years from 2010 to 2015 including infants and children who had been treated for AII in Albert Royer Children's Hospital. The following variables such as age, sex, past time before the surgical consultation, initial diagnosis, imaging data view, treatment technique and results were itemised to bear comparison. Sixty-six records were reviewed. Results: The mean age was 5.73 months with a range of 2 and 144 months. Boys constituted the majority of patients with a ratio of 2:1. Children were referred to us with the diagnosis of intestinal obstruction or gastroenteritis in 50% of cases. Past time average before consultation was 5.3 days with a range of 14 h and 30 days. Most of the patients underwent surgery within 48 h after the beginning of the clinical picture. An abdominal ultrasound scan confirmed the diagnosis of AII in 57 cases, whereas in 9 cases, it was normal or not contributive. Non-operative reduction by retrograde pneumatic pressure or barium enema represented 33.4% of patients against 56.6% for surgical treatment. We registered 5 deaths and 2 recurrences. AII remains the main cause of intestinal obstruction in infants. Conclusion: Authors stressed on delay in diagnosis with the treatment consequences belonging to that status and put emphasis in the importance of close collaboration between paediatricians, surgeons and radiologist for early diagnosis and nonoperative systematic reduction.