Intussusception in children--clinical presentation, diagnosis and management

Int J Colorectal Dis. 2009 Oct;24(10):1187-92. doi: 10.1007/s00384-009-0730-2. Epub 2009 May 6.

Abstract

Purpose: The aim of this study was to evaluate the clinical presentation, diagnosis and management of patients with intussusception, with special regard to the duration of symptoms, referral from other hospitals, outcome and complications related to delayed diagnosis.

Methods: This retrospective study was performed using hospital charts, ultrasound and radiological reports and surgical notes from patients treated in our institution from 1996-2005.

Results: Altogether 98 patients were included in the study. The study revealed idiopathic intussusception in 95% of the cases. The remaining patients presented with Meckel's diverticulum and schwannoma of the small bowel. We used ultrasound as the primary modality for diagnosis in all the patients, with a diagnostic accuracy of 100% in our study. Conservative treatment using an air enema was successful in 79.5% of cases. A higher rate of surgical intervention was found in patients who had symptoms for more than 24 h and in referred patients.

Conclusions: Particular attention needs to be paid to the rapid diagnosis and appropriate treatment of intussusception. Uncertain cases should be urgently referred to specialised paediatric centres. Ultrasound should be the diagnostic method of choice, since it is very effective in making this diagnosis. The first treatment option for intussusception remains the enema. Delayed diagnosis leads to an increased number of open surgeries.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Germany / epidemiology
  • Humans
  • Incidence
  • Infant
  • Intussusception / diagnosis*
  • Intussusception / epidemiology
  • Intussusception / therapy*
  • Male
  • Statistics, Nonparametric