Abstract
Background: Intussusception is the common cause of small intestinal obstruction in children under two years old. Late diagnosis can lead to a potentially worse condition. This prospective study aims to describe the clinical manifestation and develop the conservative management protocol for acute ileocaecal intussusception in children undertwo years old.
Methods: This prospective study was carried out in 118 consecutive patients under two years old. Patients presented with symptoms and signs of acute intestinal obstruction and diagnosis of ileocaecal intussusception confirmed by ultrasound were included in this study. All the patients were managed with either pneumatic reduction or operation.
Results: There were 70 boys and 48 girls ranging in age from three months to two years with a median of 12.5 months. Clinical presentation included abdominal pain (100%), vomiting (82.2%), bloody stool (11.9%) and a palpable mass (43.2%). Patients hospitalized with the symptoms and signs less than 24 hours were accounted for 80.5% of cases. The overall success rate of pneumatic reduction was 98.3%. Late hospital admission (≥ 24 hours from illness onset), bloody stool and presenting with the classic triad of symptoms of intussusception were found as the factors which correlated to the surgical management outcome. All patients were well recovery without any complication. The median of postoperative hospital stay was two days for pneumatic reduction group and six days for operation group.
Conclusion: Early diagnosis of intussusception contributes the success of pneumatic reduction and reduces the requires of surgical intervention.
References
Nguyễn Đình Hối, Lồng ruột, ed. Hoi. 2013: Bệnh học ngoại khoa tiêu hóa, Nhà xuất bản Y học.
Van Trang N, Le Nguyen NT, Dao HT, et al. (2014). Incidence and epidemiology of intussusception among infants in Ho Chi Minh City, Vietnam. The Journal of pediatrics. 164: 366-371.
Phạm Văn Lình, Lồng ruột cấp ở trẻ bú mẹ. Ngoại bệnh lý, ed. Linh. 2008: Nhà xuất bản Y học.
Clark AD, Hasso-Agopsowicz M, Kraus MW, et al. (2019). Update on the global epidemiology of intussusception: a systematic review of incidence rates, age distributions and casefatality ratios among children aged< 5 years, before the introduction of rotavirus vaccination. International journal of epidemiology.
Trương Nguyễn Uy Linh, Lồng ruột, ed. Linh. 2018: Ngoại nhi lâm sàng, Đại học Y Dược Thành phố Hồ Chí Minh, Nhà xuất bản Y học.
Nguyễn Thanh Liêm, Lồng ruột, ed. Liem. 2016: Phẫu thuật tiêu hóa trẻ em, Nhà xuất bản Y học. 7. Nguyễn Thị Minh Trang, Nghiên cứu đặc điểm lâm sàng, siêu âm và kết quả điều trị bệnh lồng ruột cấp ở trẻ em, ed. Trang. 2015: Luận văn thạc sĩ y học, Trường Đại học Y dược Huế.
Kumar B, Kumar M, Sinha AK, Anand U, Kumar A (2019). Intussusceptions in Children. Indian Journal of Surgery. 1-4.
Jo S, Lim IS, Chae SA, et al. (2019). Characteristics of intussusception among children in Korea: a nationwide epidemiological study. BMC pediatrics. 19: 211.
Amante S, Chaves M, Sousa R, et al. (2018). Pediatric intussusception: review and imaging contribute.
Okimoto S, Hyodo S, Yamamoto M, Nakamura K, Kobayashi M (2011). Association of viral isolates from stool samples with intussusception in children. International Journal of Infectious Diseases. 15: e641-e645.
Võ Thị Thu Thủy, Nghiên cứu lâm sàng, siêu âm, kết quả điều trị và yếu tố tiên lượng bệnh lồng ruột cấp ở trẻ dưới 24 tháng tuổi tại Bệnh viện Trung ương Huế, ed. Thuy. 2009: Luận án chuyên khoa cấp II, Trường Đại học Y Dược Huế.
Giak CL, Singh H, Nallusamy R, et al. (2008). Epidemiology of intussusception in Malaysia: a three-year review.
Satter SM, Aliabadi N, Yen C, et al. (2017). Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012–2016. Vaccine.
Trần Thế Hệ, Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và chỉ định điều trị lồng ruột cấp tính ở trẻ nhũ nhi tại Bệnh viện Trung ương Huế, ed. He. 2001: Luận văn thạc sĩ y học, Trường Đại học Y Dược Huế.
Chang Y-J, Hsia S-H, Chao H-C (2010). Emergency medicine physicians performed ultrasound for pediatric intussusceptions. International Journal of Infectious Diseases. 14.
Jo DS, Nyambat B, Kim JS, et al. (2009). Population-based incidence and burden of childhood intussusception in Jeonbuk Province, South Korea. International Journal of Infectious Diseases. 13: e383-e388.
Takeuchi M, Osamura T, Yasunaga H, et al. (2012). Intussusception among Japanese children: an epidemiologic study using an administrative database. BMC pediatrics. 12: 36.
Applegate KE, Sadigh G (2018). Intussusception in Infants and Children: Diagnostic EvidenceBased Emergency Imaging and Treatment. Evidence-Based Emergency Imaging. 567-582.
Ogundoyin OO, Olulana DI, Lawal TA (2016). Childhood intussusception: Impact of delay in presentation in a developing country. African journal of paediatric surgery: AJPS. 13: 166.
Hazra N, Karki O, Verma M, et al. (2015). Intussusception in Children: A Short-Term Analysis in a Tertiary Care Hospital. American Journal of Public Health. 3: 53-56.
Mehendale S, Kumar CG, Venkatasubramanian S, Prasanna T (2016). Intussusception in children aged less than five years. The Indian Journal of Pediatrics. 83: 1087-1092.
Bines JE, Liem NT, Justice F, et al. (2006). Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia. Bulletin of the World Health Organization. 84: 569-575.
Nguyễn Hữu Chí, Nguyễn Thị Thanh Tâm, Đào Trung Hiếu (2011). Đặc điểm lâm sàng và siêu âm lồng ruột được phẫu thuật tại Bệnh viện Nhi Đồng I. Y học Tp. Hồ Chí Minh. 3: 74-77.
Tran LAT, Yoshida LM, Nakagomi T, et al. (2013). A high incidence of intussusception revealed by a retrospective hospital-based study in Nha Trang, Vietnam between 2009 and 2011. Tropical medicine and health. 41: 121-127.
Buettcher M, Baer G, Bonhoeffer J, Schaad UB, Heininger U (2007). Three-year surveillance of intussusception in children in Switzerland. Pediatrics. 120: 473-480.
Bines JE, Ivanoff B, Justice F, Mulholland K (2004). Clinical case definition for the diagnosis of acute intussusception. Journal of pediatric gastroenterology and nutrition. 39: 511-518.
Hameed S (2006). Ultrasound guided hydrostatic reduction in the management of intussusception. The Indian Journal of Pediatrics. 73: 217-220.
Burge D (1991). Intussusception: Factors related to treatment: JAM Reijnen, C. Festen, and RP van Roosmalen. Arch Dis Child 65: 871–873,(August), 1990. Journal of Pediatric Surgery. 26: 1251.
Katz M, Phelan E, Carlin J, Beasley S (1993). Gas enema for the reduction of intussusception: relationship between clinical signs and symptoms and outcome. AJR. American journal of roentgenology. 160: 363-366.
Kuppermann N, O’Dea T, Pinckney L, Hoecker C (2000). Predictors of intussusception in young children. Archives of pediatrics & adolescent medicine. 154: 250-255.
Published | 20-02-2020 | |
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Issue | No. 59 (2020) | |
Section | Original article | |
DOI | 10.38103/jcmhch.2020.59.4 | |
Keywords | lồng ruột cấp, tháo lồng bằng hơi, tháo lồng bằng phẫu thuật. intussusception, pneumatic reduction, surgical intervention. |

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