నైరూప్య

Profile and management of children presenting with intussusception in a tertiary care hospital in Chennai: A retrospective study.

Jayakanthan Saravanan*, Suresh Babu P, Krithika AP, Ravishankar

Background: One of the most common causes of bowel obstruction in infants and children is intussusception; children under 3 years of age are more prone to idiopathic intussusception and the same is rare after 6 years of age. Infants between 4 to 10 months of age are more vulnerable. Early recognition results in an increase in the success rate for non-operative reduction which prevents significant morbidity and mortality. Non-operative reduction is considered to be the gold standard form of treatment. Aim: The primary aim of this research paper is to throw light on the profile of children who presented with intussusception, for the first time, to our tertiary care institute which caters to the urban and semi-urban population of Chennai and, also we have analyzed the success rate of Pneumatic reduction Results: During the study period, 71 cases were identified, of which 5 cases were recurrent intussusception. So, 66 cases were included from the study period. 51 (77%) children were less than 3 years of age, 12 (18%) children were between 3 and 6 years, and only 3 children (4%) were above 6 years of age. N=41 (62%) children were male and N=25 (37%) were female. N=40 (60%) children presented within 24 hours of the onset of symptoms, and N=21 (31%) children presented from 24 to 48 hours of onset of symptoms and n=5 (7%) children presented after 48 hours. N=58 (89%) children had successful pneumatic reduction under fluoroscopy in the first attempt; on the other hand, N=4 (6%) children required more than one attempt. N=4(5%) children needed operative intervention, 2 of them due to failed reduction and 2 due to lead points confirmed by CT, Meckel's diverticulum and lymphoma respectively. Conclusion: One of the most frequently encountered pediatric surgical emergencies is intussusception that can be managed non-operatively by the procedure of pneumatic reduction. Failure of pneumatic reduction occurs whenever there is a delay in presentation or diagnosis. The success of non-operative management i.e. pneumatic reduction depends on the skill and experience of pediatric surgeons.