How Effective is Non-surgical Management in Pediatric Intussusception?

Abstract

Introduction: Intussusception is common in infants and young children. Healthy babies are prone to this problem. Severe intermittent pain, vomiting, pallor, and sweating are suspicious to this problem. Early diagnosis helps to prevent surgical intervention. Late presentation may lead to intestinal perforation and serious complications.

Methods: Diagnosed cases of intussusception within a year at TUTH were studied prospectively. Patients initially evaluated with ultra sonogram. Patients without complications and contra indications were taken to the radiology department for reduction by non-surgical method (Barium enema). Complicated and contraindicated cases managed surgically.

Results: Total 21 cases admitted within a year. Male: Female ratio was 2:1. Mean age at presentation was 20.05 months (5 - 48 months). The average symptoms duration was 36.11 (6-72) hours. Abdominal pain & cry, vomiting, and blood in stool were common presenting symptoms.

Among 21 cases, 18 underwent non-surgical procedure: two were contra indicated for it and one self reduced. In non-surgically managed group 13 had successful reduction and five failed. Failed cases were managed surgically.

In our series, two recurrences noticed. One in surgically managed group, presented after five months of surgery and managed successfully with non-surgical method. Second case was in non-surgical group, presented after three months of first reduction. This was also managed successfully by non-surgical technique.

Conclusion: Early detection and complete diagnosis of pediatric intussusception is desirable for non-surgical management. Surgical intervention is considered only in contra indications, unsuccessful, and perforation during non-surgical procedures. Ultrasonography is the diagnostic choice but operator’s variation should consider.