Experience of Diagnosis and Treatment of Intussusception in Children

O. Fofanov, O. Borys, R. Nykyforuk, V. Fofanov, I. Krasivs'kij

Abstract


The objective of the research was to establish the causes of complications of intestinal intussusception in children as well as to determine the optimal diagnostic and treatment strategy.

Materials and methods. The analysis of medical records and examinations of 100 children with intestinal intussusception at the age of 1 month to 17 years who were treated at the clinic of pediatric surgery of the Ivano-Frankivsk National Medical University was made. Ileocecal intussusception was diagnosed in 77 children; 13 patients had small intestinal intussusception; there were no patients with colonic intussusception; in 10 patients the localization of intussusception was not established. Treatment of intestinal intussusception was performed urgently immediately after the diagnosis. High priority was given to conservative treatment (74 patients); it was effective in 64 (86.5%) patients. The remaining 36 patients underwent surgery, 9 (25%) of them underwent a laparoscopic disinvagination. In 27 cases open surgery – disinvagination – was used.

Results and discussion. The typical age (4-12 months) was observed in 50% of patients only, however, 38% of patients were over 1 year of age, and 20% of children were older than 3 years. All children with intestinal intussusception recovered. The complications of intestinal intussusception were observed in 7 patients, most of them were admitted to the clinic 24 hours after the onset of the disease. Re-laparotomy was used in three cases; two patients underwent elective (programmed re-laparotomy) and one patient underwent urgent re-laparotomy due to the presence of signs of peritonitis. Recurrent intussusception was observed in 5 patients; 4 patients developed this condition after conservative disinvagination, one child - after surgery.

Conclusions.

  1. The complications of intussusception in children are usually associated with untimely diagnosis and treatment.
  2. Diagnostic laparoscopy is a highly informative method of diagnosis in the absence of typical symptoms of intussusception being also an effective minimally invasive treatment.
  3. When selecting the method of intussusception treatment you should be guided by the duration of rectal bleeding and Doppler data being the most important criteria for determining the degree of the impairment of hemomicrocirculation in the invaginated intestine.
  4. Conservative disinvagination is the priority method of treating intussusception. 

 


Keywords


Intussusception; treatment; children.

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DOI: http://dx.doi.org/10.21802/gmj.2016.3.13

Copyright (c) 2017 O. Fofanov, O. Borys, R. Nykyforuk, V. Fofanov, I. Krasivs'kij

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