G Staatz1, G Alzen, G Heimann. 1. Klinik für Radiologische Diagnostik, Universitätsklinikum, RWTH Aachen.
Abstract
BACKGROUND: Intussusception is the most common cause of an acute abdomen in early childhood. 90% of all intussusceptions were thought to be idiopathic, because no lead points could be evaluated. PATIENTS: In our study we examined 148 children (93 boys and 55 girls) between 2. month and 18. years of age with 155 intussusceptions. METHOD: Besides epidemiological features and patients history we determined systematically all symptoms which occurred since the beginning of sickness. We performed ultrasound examinations before and after hydrostatic reduction with each child in order to find pathologic lead points. Microbiologic stool examination could be carried out at 99 specimen. RESULTS: 41 of 155 children with intussusception (26.5%) showed a pathologic finding next to the intussusception, with 29 children (18.7%) suffering from mesenteric lymphadenitis. 60.6% of examined stool specimen were abnormal. The most common germs were adenovirus, yersinia and staphylococcus aureus. Abdominal pain was the main symptom and was found in 72.6% of all children. 21% suffered from the classic trias abdominal pain, vomiting and rectal bleeding. 21.9% had diarrhea and 18% fever and signs of inflammation as unspecific symptoms. CONCLUSIONS: In our study we found mesenteric lymphadenitis as the most common lead point in intussusception. In conclusion with 60.6% pathologic germs in the examined stool specimen we assume gastrointestinal infection as the main cause of intussusception in childhood.
BACKGROUND: Intussusception is the most common cause of an acute abdomen in early childhood. 90% of all intussusceptions were thought to be idiopathic, because no lead points could be evaluated. PATIENTS: In our study we examined 148 children (93 boys and 55 girls) between 2. month and 18. years of age with 155 intussusceptions. METHOD: Besides epidemiological features and patients history we determined systematically all symptoms which occurred since the beginning of sickness. We performed ultrasound examinations before and after hydrostatic reduction with each child in order to find pathologic lead points. Microbiologic stool examination could be carried out at 99 specimen. RESULTS: 41 of 155 children with intussusception (26.5%) showed a pathologic finding next to the intussusception, with 29 children (18.7%) suffering from mesenteric lymphadenitis. 60.6% of examined stool specimen were abnormal. The most common germs were adenovirus, yersinia and staphylococcus aureus. Abdominal pain was the main symptom and was found in 72.6% of all children. 21% suffered from the classic trias abdominal pain, vomiting and rectal bleeding. 21.9% had diarrhea and 18% fever and signs of inflammation as unspecific symptoms. CONCLUSIONS: In our study we found mesenteric lymphadenitis as the most common lead point in intussusception. In conclusion with 60.6% pathologic germs in the examined stool specimen we assume gastrointestinal infection as the main cause of intussusception in childhood.
Authors: Kristin E Killoran; Amber D Miller; Karen S Uray; Norman W Weisbrodt; Robia G Pautler; Sanna M Goyert; Nico van Rooijen; Margaret E Conner Journal: Am J Physiol Gastrointest Liver Physiol Date: 2014-01-09 Impact factor: 4.052