Clinical characteristics and predictors for the presence of pediatric intussusception secondary to pathological lead points

Abstract Purpose: Analyze the clinical characteristics and identify independent predictors of intussusception secondary to pathological lead points (PLPs). Methods: Children admitted with intussusception between 2010 and 2025 were retrospectively enrolled after surgery and divided into two groups: the PLPs group and the non-PLPs group and tested for differences in demography, symptomatology, auxiliary examinations, surgical results and pathological results. Results: A total of 575 cases of intussusception were included in the final analysis of which 183 had PLPs and 392 were idiopathic. The types of PLPs included lymphadenitis/lymphoid hyperplasia, Meckel's diverticulum, intestinal duplication malformations, polyps, tumors, appendicitis, ectopic gastric mucosa, ectopic pancreas, enterocyst, allergic purpura, parasite, ileocecal ulceration. Multivariable analysis revealed that older age (OR=1.020; 95%CI, 1.008-1.032; p<0.001), hematochezia (OR=0.540; 95% CI, 0.315-0.927; p=0.026), abdominal pain (OR=2.122; 95%CI, 1.092-4.123; p=0.028), recurrence (OR=4.430; 95% CI, 2.265-8.664; p<0.001), intestinal necrosis (OR=4.441; 95%CI, 2.730-7.224; p<0.001), and exp(PCT) (OR=16.077; 95%CI, 3.749-69.942; p<0.001) were independent predictors of PLPs. Conclusions: Lymphadenitis/lymphoid hyperplasia is the most common PLP of intussusception. Older age, hematochezia, abdominal pain, recurrence intussusception, intestinal necrosis and thrombocytocrit are independent predictors of PLPs.