Seasonality and surgical management of intussusception over 10 years at Harare Children’s Hospital

Abstract

Objectives:  To determine the number of patients with intussusception treated at HCH over a 10 year period.  To describe the ages and sex of children operated for intussusceptions. To determine if there is seasonal variation in the number of cases presenting to HCH.  To determine the type and method of treatment of intussusception at HCH.

Design: This was a descriptive retrospective study. Theatre records were inspected to identify eligible patients. Information regarding sex, age, anatomical subtype and procedure performed was recorded.

Setting:  Harare Central Hospital, Zimbabwe.

Subjects: Two hundred and seventeen (217) participants were enrolled. All patients who underwent surgery for intussusception between September 2003 and August 2013 were eligible. One re-operation was excluded.

Results:  There were 129 boys and 83 girls. The modal age was 6 months. 61.3% of patients had ileo-colic intussusception, 4.1% colo-colic and 0.5% ileo-ileal. The peak incidence was in September. There was an increase in annual cases in the period under review from 9 cases in 2003/2004 to 34 cases in the 2012/2013 period. 47.5%of patients had resection and primary anastomosis while 24.0% had manual reduction at laparotomy.

Conclusion:  Intussusception is one of the most common paediatric surgical emergencies at Harare Central Hospital. The age and sex of patients are the same as those found in literature. In contrast with previous data, a strong statistically significant seasonal incidence was observed. The majority of cases were ileo-colic. The most common procedure at laparotomy was resection as opposed to manual reduction.