Small bowel intussusception in children: single-centre observations

• Main Authors: Jan Stanisław Bukowski, Przemysław Bombiński, Jakub Franke, Michał Brzewski
• Format: Article
• Language: English
• Published: Medical Communications Sp. z o.o. 2019-11-01
• Series: Pediatria i Medycyna Rodzinna
• Subjects: ultrasonography; small bowel intussusception; bowel intussusception
• Online Access: http://www.pimr.pl/index.php/issues/2019-vol-15-no-3/small-bowel-intussusception-in-children-single-centre-observations?aid=1381

Aim: Small bowel intussusception is an increasingly prevalent condition reported in paediatric patients. The aims of the study were to characterise a group of patients with ultrasonographically confirmed intussusception, and review the therapeutic approach used in each case. Material and methods: This retrospective cross-sectional study enrolled a total of 40 children treated at a paediatric hospital who had been diagnosed with small bowel intussusception on the basis of ultrasound examination findings. Results: 80% of children had a single-site small bowel intussusception, and 20% of patients – a double-site intussusception or a small bowel intussusception coexisting with ileocaecal intussusception. The children presented with uncharacteristic symptoms such as abdominal pain, diarrhoea, vomiting and fever. The majority of cases (87.5%) were patients referred from the hospital accident and emergency department. More than half of the intussusceptions (55%) were found in children between 2 and 5 years of age, slightly more frequently in boys than in girls (22:18). Most of the intussusceptions (56%) were located in the middle abdomen. 66.6% of the intussusceptions were <30 mm in length. Only 6.67% of children required laparotomy. In the remaining cases, it was possible to achieve reduction of intussusception by using conservative treatment. The intussusception resolved already during the first ultrasound examination in 12.5% of children, and in only 27.5% of patients it was also present during the second scan which was performed at least 4 hours later. Conclusions: Intussusception length is one of the most important parameters determining the type of treatment to be used. Surgical reduction may be necessary in cases of small bowel intussusception with a length of ≥35 mm. Each case should be considered individually, and follow-up ultrasound scans should be performed not only after detecting small bowel intussusception, but also immediately before surgery.