Childhood Intussusception: 10-year Experience at Children’s Clinical University Hospital in Riga
semanticscholar(2018)
摘要
Intussusception is the most common cause of intestinal obstruction in children between the age of 3 months and 3 years. Non-surgical methods are the main treatment, but still intussusception reduction techniques remain varied and controversial. The aim of the study was to review the experience of Children’s Clinical University Hospital in the management of intussusception over the last 10 years, with a focus on assessing the efficacy of nonoperative reduction. Retrospective descriptive study was conducted at Children’s Clinical University Hospital, Riga. The study included data from medical records of patients with intussusception between January 2006 and December 2015 at the hospital. Patients’ demographics, clinical presentation, treatment modalities, recurrence and length of hospital stay were studied. The method of non-operative reduction was pneumatic reduction. Data analysis was carried out using the Microsoft Excel and IBM SPSS Statistics. Results were considered statistically significant with CI > 95 %, p < 0.05. The study included 148 patients (93 males, 55 females), ratio 1.7 : 1. Mean age 23.7 ± 27.4 months (range 2 to 161 month). Duration of presenting symptoms 18 ± 17 h, most common symptom – abdominal pain (83.1 %). Main diagnostic method – abdominal sonography, made in 81.1 %, with sensitivity of 95.8 %. Secondary intussusception found in 4.7 % with Meckel’s diverticulum (n = 5) and polyp (n = 2) as lead point. Pneumatic reduction was performed in 85 patients, with success rate of 82.5 %. In surgical group (n = 61) predominantly laparotomy with manual reduction in 24.3 % was used. The overall recurrence rate was 6.8 %. Mean hospital stay was 4.6 days, in non-surgical group 2.5 days vs. surgical group 7.5 days (p < 0.01). Pneumatic reduction is the main intussusception treatment method at Children’s Clinical University Hospital. There is no statistically significant correlation between patient’s age, length of symptoms and pneumatic reduction success rate. Pneumatic reduction is minimally invasive for patients, has high success rate (82.5 %) and low complication rate, decreases length of hospital stay.
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