Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong

Hong Kong Med J. 2015 Dec;21(6):518-23. doi: 10.12809/hkmj144456. Epub 2015 Sep 11.


Objectives: To review all paediatric patients with intussusception over the last 17 years.

Design: Retrospective case series.

Setting: A tertiary centre in Hong Kong.

Patients: Children who presented with intussusception from January 1997 to December 2014 were reviewed.

Main outcome measures: The duration of symptoms, successful treatment modalities, complication rate, and length of hospital stay were studied.

Results: A total of 173 children (108 male, 65 female) presented to our hospital with intussusception during the study period. Their median age at presentation was 12.5 months (range, 2 months to 16 years) and the mean duration of symptoms was 2.3 (standard deviation, 1.8) days. Vomiting was the most common symptom (76.3%) followed by abdominal pain (46.2%), per rectal bleeding or red currant jelly stool (40.5%), and a palpable abdominal mass (39.3%). Overall, 160 patients proceeded to pneumatic or hydrostatic reduction, among whom 127 (79.4%) were successful. Three (1.9%) patients had bowel perforation during the procedure. Early recurrence of intussusception occurred in four (3.1%) patients with non-operative reduction. No recurrence was reported in the operative group. The presence of a palpable abdominal mass was a risk factor for operative treatment (relative risk=2.0; 95% confidence interval, 1.8-2.2). Analysis of our results suggested that duration of symptoms did not affect the success rate of non-operative reduction.

Conclusions: Non-operative reduction has a high success rate and low complication rate, but the presence of a palpable abdominal mass is a risk factor for failure. Operative intervention should not be delayed in those patients who encounter difficult or doubtful non-operative reduction.

Keywords: Child; Intussusception/surgery.

MeSH terms

  • Abdominal Neoplasms / etiology
  • Abdominal Neoplasms / surgery
  • Abdominal Pain / etiology
  • Adolescent
  • Child
  • Child, Preschool
  • Digestive System Surgical Procedures / adverse effects
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Hong Kong
  • Humans
  • Infant
  • Intestinal Diseases / complications*
  • Intestinal Diseases / surgery
  • Intestinal Perforation / etiology
  • Intussusception / complications*
  • Intussusception / surgery
  • Length of Stay
  • Male
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers
  • Treatment Outcome
  • Vomiting / etiology