AIMS: To review the demographics, presenting features, rates of air enema reduction success, prevalence of pathological lead points and surgical intervention rates and outcomes in patients with intussusception at Starship Children's Hospital (Auckland, New Zealand). To use this data to guide management of children at a national level in New Zealand. METHOD: Retrospective case series. Patients discharged from Starship Children's Hospital between 1 January 1998 and 31 December 2007 with a diagnosis of intussusception were obtained from coding data. RESULTS: 189 patients were analysed. 30% presented with the classic triad of pain, rectal bleeding and mass. 150/189 proceeded to air enema reduction which was successful in 118 (78.7%) of cases with 2 perforations. 54/189 (28.6%) proceeded for operative reduction of which 26 patients required surgical resection. Clinical and radiological evidence of bowel obstruction and duration of symptoms were associated with failed enema and surgical resection. CONCLUSION: Intussusception only occasionally presents with the typical triad of abdominal pain, rectal bleeding and abdominal mass. Air enema reduction is successful at this institution with a low level of complication. Maori and Pacific patients had higher rates of failed enema reduction and need for surgery compared to European patients. Further research is needed from peripheral centres to evaluate outcomes of children treated in district hospitals to identify how and where these children are best managed.
AIMS: To review the demographics, presenting features, rates of air enema reduction success, prevalence of pathological lead points and surgical intervention rates and outcomes in patients with intussusception at Starship Children's Hospital (Auckland, New Zealand). To use this data to guide management of children at a national level in New Zealand. METHOD: Retrospective case series. Patients discharged from Starship Children's Hospital between 1 January 1998 and 31 December 2007 with a diagnosis of intussusception were obtained from coding data. RESULTS: 189 patients were analysed. 30% presented with the classic triad of pain, rectal bleeding and mass. 150/189 proceeded to air enema reduction which was successful in 118 (78.7%) of cases with 2 perforations. 54/189 (28.6%) proceeded for operative reduction of which 26 patients required surgical resection. Clinical and radiological evidence of bowel obstruction and duration of symptoms were associated with failed enema and surgical resection. CONCLUSION: Intussusception only occasionally presents with the typical triad of abdominal pain, rectal bleeding and abdominal mass. Air enema reduction is successful at this institution with a low level of complication. Maori and Pacific patients had higher rates of failed enema reduction and need for surgery compared to European patients. Further research is needed from peripheral centres to evaluate outcomes of children treated in district hospitals to identify how and where these children are best managed.
Authors: Edward John Hannon; Rosemary Anne Allan; April Samantha Negus; Feilim Murphy; Bruce Obi Okoye Journal: Pediatr Surg Int Date: 2013-06-04 Impact factor: 1.827