Acute intussusception is a common pediatric acute abdomen, classified into idiopathic (unknown cause, common in infants) or secondary (caused by organic intestinal lesions) according to the cause of the disease. The preferred treatment is enema, but children who fail enema require surgical treatment. This study aims to improve the diagnosis and treatment of pediatric intussusception by summarizing and analyzing the clinical characteristics of children undergoing multicenter intussusception surgery. This retrospective study analyzed data from children under 14 years old who underwent surgery for intussusception after failed air enema at six Chinese hospitals (between January 2019 and January 2022). Patients were divided into idiopathic and secondary groups based on surgical findings. Data collection included basic information, clinical symptoms, laboratory results, surgical indicators, and hospitalization details. A total of 189 children were included, with 136 boys (71.96%) and 53 girls (28.04%). After surgery, 148 (78.3%) were classified as idiopathic intussusception and 41 (21.7%) as secondary. The idiopathic group had lower average age (20.20 ±21.67 months vs. 49.49 ±33.98 months) and weight (10.55 ±3.94 kg vs. 16.63 ±7.52 kg). The secondary group had higher bloody stool rate (63.41% vs. 36.49%, P=0.002), longer surgery and hospitalization times, and higher costs. Intestinal necrosis occurred in 16 cases (8.78% idiopathic, 7.32% idiopathic). In the secondary group, common causes were Meckel’s diverticulum (31.7%), intestinal duplication (17.1%), and non-Hodgkin lymphoma (14.6%). Logistic regression showed body weight (cut-off: 10.75 kg) was an independent influencing factor. Significant clinical differences exist between idiopathic and secondary intussusception. Secondary patients were older, heavier, with longer surgery/hospitalization times and higher costs. Heavier children with bloody stools should be closely monitored for secondary intussusception. Future research should validate these results and explore optimal treatment strategies.
Liu et al. (Fri,) studied this question.