Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases
Objectives The primary objective of this study was to analyze and review the demographics of children operated upon for intussusception. Secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and outcome. Materials and...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2021-10-01
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| Series: | Annals of the National Academy of Medical Sciences (India) |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739034 |
| _version_ | 1819103294346231808 |
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| author | Rajendra K. Ghritlaharey |
| author_facet | Rajendra K. Ghritlaharey |
| author_sort | Rajendra K. Ghritlaharey |
| collection | DOAJ |
| description | Objectives The primary objective of this study was to analyze and review the demographics of children operated upon for intussusception. Secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and outcome.
Materials and Methods It is a single-institution, retrospective study and consists of children below the age of 12 years. This study was conducted at the author’s department of pediatric surgery for the past 21 years, from January 1, 2000 to December 31, 2020.
Results During the study period, 212 children were operated upon for intussusceptions and included 146 (68.86%) boys and 66 (31.13%) girls. This review consisted of infants 158 (74.52%), and children of 1 to 5 years of age (30; 14.15%), and 6 to 12 years of age (24; 11.32%). Clinically, 177 (83.49%) children presented with the features of acute intestinal obstruction, and the remaining 35 (16.5%) presented with features of perforation peritonitis. Primary (idiopathic) intussusception was documented in 188 (88.67%) of the cases. Gangrenous bowel was evident in 98 (46.22%) children. Sixty-two percent of the cases required bowel resection. Surgical procedures were executed in children for intussusception in the following order of frequency: (1) operative reduction with or without serosal tear/bowel perforation repair, n = 81 (38.2%); (2) resection of diseased ileum and ileoileal anastomosis, n = 52 (24.52%); (3) resection of diseased ileum ± part of colon and an ileostomy, n = 36 (16.98%); and (4) resection of diseased ileum, cecum, part of colon, and ileocolic (ileo-ascending or ileo-transverse) anastomosis, n = 43 (20.28%). Postoperatively, 9 (4.24%) children required reexploration for the management of their complications. Twenty-one (9.9%) children died during the postoperative period.
Conclusion Intussusception remains the most common cause of acute intestinal obstruction in infants and young children. Delay in the referral, diagnosis, and seeking treatment were significantly associated with bowel gangrene, required bowel resection during the surgical therapy, and also culminated in significantly higher mortalities. |
| first_indexed | 2024-12-22T01:48:10Z |
| format | Article |
| id | doaj.art-906abf4429ad4e70b2d6c4089328dc3d |
| institution | Directory Open Access Journal |
| issn | 0379-038X 2454-5635 |
| language | English |
| last_indexed | 2024-12-22T01:48:10Z |
| publishDate | 2021-10-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Annals of the National Academy of Medical Sciences (India) |
| spelling | doaj.art-906abf4429ad4e70b2d6c4089328dc3d2022-12-21T18:43:00ZengThieme Medical and Scientific Publishers Pvt. Ltd.Annals of the National Academy of Medical Sciences (India)0379-038X2454-56352021-10-01570422623110.1055/s-0041-1739034Surgical Management of Intussusception in Children: A Retrospective Review of 212 CasesRajendra K. Ghritlaharey0Department of Pediatric Surgery, Gandhi Medical College and Associated Kamla Nehru and Hamidia Hospitals, Bhopal, Madhya Pradesh, IndiaObjectives The primary objective of this study was to analyze and review the demographics of children operated upon for intussusception. Secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and outcome. Materials and Methods It is a single-institution, retrospective study and consists of children below the age of 12 years. This study was conducted at the author’s department of pediatric surgery for the past 21 years, from January 1, 2000 to December 31, 2020. Results During the study period, 212 children were operated upon for intussusceptions and included 146 (68.86%) boys and 66 (31.13%) girls. This review consisted of infants 158 (74.52%), and children of 1 to 5 years of age (30; 14.15%), and 6 to 12 years of age (24; 11.32%). Clinically, 177 (83.49%) children presented with the features of acute intestinal obstruction, and the remaining 35 (16.5%) presented with features of perforation peritonitis. Primary (idiopathic) intussusception was documented in 188 (88.67%) of the cases. Gangrenous bowel was evident in 98 (46.22%) children. Sixty-two percent of the cases required bowel resection. Surgical procedures were executed in children for intussusception in the following order of frequency: (1) operative reduction with or without serosal tear/bowel perforation repair, n = 81 (38.2%); (2) resection of diseased ileum and ileoileal anastomosis, n = 52 (24.52%); (3) resection of diseased ileum ± part of colon and an ileostomy, n = 36 (16.98%); and (4) resection of diseased ileum, cecum, part of colon, and ileocolic (ileo-ascending or ileo-transverse) anastomosis, n = 43 (20.28%). Postoperatively, 9 (4.24%) children required reexploration for the management of their complications. Twenty-one (9.9%) children died during the postoperative period. Conclusion Intussusception remains the most common cause of acute intestinal obstruction in infants and young children. Delay in the referral, diagnosis, and seeking treatment were significantly associated with bowel gangrene, required bowel resection during the surgical therapy, and also culminated in significantly higher mortalities.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739034childreninfantintestinal obstructionintussusceptionbowel gangrenepathological lead point |
| spellingShingle | Rajendra K. Ghritlaharey Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases Annals of the National Academy of Medical Sciences (India) children infant intestinal obstruction intussusception bowel gangrene pathological lead point |
| title | Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases |
| title_full | Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases |
| title_fullStr | Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases |
| title_full_unstemmed | Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases |
| title_short | Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases |
| title_sort | surgical management of intussusception in children a retrospective review of 212 cases |
| topic | children infant intestinal obstruction intussusception bowel gangrene pathological lead point |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739034 |
| work_keys_str_mv | AT rajendrakghritlaharey surgicalmanagementofintussusceptioninchildrenaretrospectivereviewof212cases |