A E Archibong1, I N Usoro, E Ikpi, A Inyang. 1. Paediatric Surgery Unit, Department of Surgery, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
Abstract
OBJECTIVES: To determine prevalence, clinical presentation, evaluate management methods and outcome of paediatric intussusception in Calabar. DESIGN: A retrospective study. SETTING: University of Calabar Teaching Hospital, Calabar, Nigeria. PARTICIPANTS: All cases of intussusception in children that presented at the children emergency Room and Surgical Outpatient Department of the University of Calabar Teaching Hospital between 1989 and December 1998. RESULTS: The mean age was 7.5 months with a male:female ratio of 1.8:1. The main presenting symptoms were vomiting in 76 (85.3%) patients, general irritability in 69 (77.5%) patients, bleeding per rectum in 47 (52.8%) patients and palpable abdominal mass in 38 cases (42.6%). Majority of the patients presented late to hospital beyond 36 hours since onset of illness and had had enema administration before presentation, a popular phenomenon in the region. Diagnosis of this condition was confirmed clinically in fifty nine patients (66%). Eighty one patients (91%) had laparotomy, the only method of treatment available with simple manual reduction while in eight patients (9%) laparotomy was accompanied with resection and anastomosis for bowel with doubtful viability. CONCLUSION: Time lapse from onset to presentation is not a criterion for choosing between operative and non-operative reduction. The clinical status and abdominal evaluation of the patients are the important features to consider. Operative reduction in most instances involve manual reduction hence should be preceded by conservative methods of reduction.
OBJECTIVES: To determine prevalence, clinical presentation, evaluate management methods and outcome of paediatric intussusception in Calabar. DESIGN: A retrospective study. SETTING: University of Calabar Teaching Hospital, Calabar, Nigeria. PARTICIPANTS: All cases of intussusception in children that presented at the children emergency Room and Surgical Outpatient Department of the University of Calabar Teaching Hospital between 1989 and December 1998. RESULTS: The mean age was 7.5 months with a male:female ratio of 1.8:1. The main presenting symptoms were vomiting in 76 (85.3%) patients, general irritability in 69 (77.5%) patients, bleeding per rectum in 47 (52.8%) patients and palpable abdominal mass in 38 cases (42.6%). Majority of the patients presented late to hospital beyond 36 hours since onset of illness and had had enema administration before presentation, a popular phenomenon in the region. Diagnosis of this condition was confirmed clinically in fifty nine patients (66%). Eighty one patients (91%) had laparotomy, the only method of treatment available with simple manual reduction while in eight patients (9%) laparotomy was accompanied with resection and anastomosis for bowel with doubtful viability. CONCLUSION: Time lapse from onset to presentation is not a criterion for choosing between operative and non-operative reduction. The clinical status and abdominal evaluation of the patients are the important features to consider. Operative reduction in most instances involve manual reduction hence should be preceded by conservative methods of reduction.