INTUSSUSCEPTION IN INFANTS AND CHILDREN - A REVIEW OF 60 CASES

Sixty pediatric patients with intussusception seen at Maternity and Children's Hospital over 2.5 years were retrospectively reviewed. There were 33 males and 27 females ranging in age from 1.5 months to 108 months with a mean of 11.5 months. Seventeen patients (28.3%) presented more than 48 hours after their symptoms started. Vomiting was the most common symptom (93.3%) followed by rectal bleeding (71.68) and abdominal pain (48.3%). The clinical signs included the presence of blood per rectal examination in 58.3% of patients and palpable mass in 46.6% of patients. Most intussusceptions were of ileocolic type (88%). Hydrostatic barium enema reduction was tried in 50 patients (83.3%) with an overall success rate of 56%. Fify-three percent of patients had surgical treatment for their intussusception. Ten patients (16.6%) required bowel resection. The leading point was identified in 10% of patients. Meckel's diverticulum was the most common finding. The average hospital stay was two to five days after barium reduction and seven days after surgical treatment. There were no deaths. One patient had perforation of the bowel during hydrostatic reduction and another had chest infection postoperatively. There were no recurrences in our series. In conclusion, it appears that failure to diagnose intussusception in the first 24 hours will decrease the successful rate of hydrostatic reduction and increase the need for surgical intervention and the period of hospitalization. Barium enema reduction is the treatment of choice in all cases unless contraindicated. The clinical pattern of intussusception in this part of the world is more or less the same as in other countries.