Intussusception: A short term retrospective analysis

Background: Intussusception is the most common abdominal emergency in infants and small children.There has been great progress in diagnostic and therapeutic management of this condition.The incidence of intussusception is very high among the paediatric population in Central Travancore.Aim: The purpose of our review was to analyse the clinical presentation, atypical manifestations in particular, diagnostic modalities, treatment options and also to analyse the non-idiopathic variety of intussusception admitted to our hospital.Materials and Methods: We performed a retrospective analysis of all intussusception cases seen at the Department of Paediatric Surgery from June 2011 to January 2012.Twenty nine patients with radiological evidence of intussusception were included in the study.The data obtained included age, sex, clinical presentation, diagnostic procedures, mode of treatment, and results.Patients included children from one month to 12 years of age.Of all, 64 percent of children were under one year of age, and 66% were boys.The duration of symptoms before treatment was less than 24 hours in 38%, 24-48 hours in 28%, and more than 48 hours in 34% of patients.Results: A significant number of babies presented with atypical features.There were two children with no pain at all, and three with urticaria as the presenting symptom.One baby was brought with features mimicking epilepsy.The success rate of hydrostatic reduction was 95.4%.Four patients underwent surgery and, among these, abnormalities in the intestinal wall necessitated resection in two cases.An association between the duration of symptoms and the outcome of the non-surgical treatment was not very evident in our study, as compared to earlier literature.Conclusion: Identifying atypical presentations and early diagnosis is very important to avoid unnecessary morbidity and mortality.Hydrostatic enema is a safe and effective approach for uncomplicated intussusception reduction with a high success rate, but the older age groups need surgical exploration, especially when in doubt regarding a specific diagnosis.