Eileen Yap Shiyi1, Sashikumar Ganapathy. 1. From the Departments of *Paediatric Medicine and †Emergency Medicine, KK Women's and Children's Hospital, Singapore.
Abstract
OBJECTIVE: This project examines the presenting complaints of children with intussusception in the emergency department in an Asian population, with a focus on older children, which has not been well described in previous studies. METHODS: A retrospective study was conducted on children aged 6 months to 15 years, whose conditions were diagnosed with intussusception in KK Women's and Children's Hospital for a 5-year period (2009-2013), based on the case definition established by the Brighton Collaborate Intussusception Working Group. RESULTS: Three hundred ninety-one cases were identified to fulfill the case definition as per the Brighton Collaborative Intussusception Working Group. The mean age of children diagnosed with intussusception is 2.59 years, predominantly in males (65.22%). A total of 3.33% were 10 years or older. Only 3.58% presented with the classical triad-intermittent abdominal pain, vomiting, and bloody stools. In contrast, 22.51% of our Asian patients presented with a triad of intermittent abdominal pain, indrawing of legs, and vomiting. A total of 76.73% of our subjects were treated by air enema only, whereas 22 required surgical treatment after unsuccessful attempts of air enema, and 63 resolved spontaneously, including 7 with ileoileal intussusception. No mortality was documented. CONCLUSIONS: Intussusception is usually diagnosed in the younger population (age <1 year) and predominantly in males. Our study has established that older Asian children can also have intussusception. The classical triad is not a very sensitive diagnostic tool, but the combination of abdominal pain, indrawing of legs, and vomiting may be a more common presenting triad in Asian children.
OBJECTIVE: This project examines the presenting complaints of children with intussusception in the emergency department in an Asian population, with a focus on older children, which has not been well described in previous studies. METHODS: A retrospective study was conducted on children aged 6 months to 15 years, whose conditions were diagnosed with intussusception in KK Women's and Children's Hospital for a 5-year period (2009-2013), based on the case definition established by the Brighton Collaborate Intussusception Working Group. RESULTS: Three hundred ninety-one cases were identified to fulfill the case definition as per the Brighton Collaborative Intussusception Working Group. The mean age of children diagnosed with intussusception is 2.59 years, predominantly in males (65.22%). A total of 3.33% were 10 years or older. Only 3.58% presented with the classical triad-intermittent abdominal pain, vomiting, and bloody stools. In contrast, 22.51% of our Asian patients presented with a triad of intermittent abdominal pain, indrawing of legs, and vomiting. A total of 76.73% of our subjects were treated by air enema only, whereas 22 required surgical treatment after unsuccessful attempts of air enema, and 63 resolved spontaneously, including 7 with ileoileal intussusception. No mortality was documented. CONCLUSIONS: Intussusception is usually diagnosed in the younger population (age <1 year) and predominantly in males. Our study has established that older Asian children can also have intussusception. The classical triad is not a very sensitive diagnostic tool, but the combination of abdominal pain, indrawing of legs, and vomiting may be a more common presenting triad in Asian children.