Diagnosis and treatment of pediatric intussusception: 5-year experience

Abstract

Introduction: Intussusception is relatively common cause of intestinal obstruction in children. The aim of this study was to evaluate the diagnostic value of applied diagnostic procedures and to define the most appropriate treatment option for intussusception. Methods: Retrospective study included all children clinically suspected of having intussusception in a 5 year period, from 1-january-2005 to 31-december-2009. As data base were used features from hospital charts, ultrasound reports and surgical notes. Results: Among 378 patients with clinically suspected intussusception, it was confirmed in 76 patients. The average age of patients with a positive finding was 1 year 7 months. Predominant signs and symptoms were abdominal pain (94.7%), vomiting (61.8%) and red currant jelly stool (53.9%). Previous infection was reported in 17 (22.36%) patients. There was no seasonal distribution of appearance of invaginations. Ileocecal form was found in 71 patients (93.42%). The head of the intussusceptum was mostly localized in the area of the hepatic flexure (28.94%). Pathologic lead points were indentified in 3 cases. Hydrostatic reduction was successful in 61 out of 74 patients (82.43%). Surgical treatment was required in 15 patients (19.73%). The average hospital length of stay for patients who had hydrostatic reduction was 3.4 days, while for patients undergoing surgery was 7.7 days. Diagnostic accuracy of clinical diagnosis was 96,5%, and of ultrasonographic diagnosis 97,5%. Conclusion: Ultrasonography, as a safe procedure, has become a gold standard in diagnosis and minimally invasive treatment of intussusception in pediatric patients.