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Intussusception in Infants, Experience from Lagos, Nigeria
Abstract
Worlwide, intussusception is a fairly common surgical emergency in infants. They often present in ways that mimmick dysenteric diarrheoa, and accurate diagnosis requires both an awareness of its modes of presentation and a healthy index of suspicion. We reviewed and analysed several epidemiologic and clinical parameters as well as management options in cases of intussusception in infants and children treated at the Lagos State University Teaching Hospital between January 2006 and December 2006. There were 33 cases in all. All of them had operative
management. The commonest type was ileo-colic intussusception (91%). There was no definite pathologic lead point but enlarged Peyer’s patches were noticed in 5 cases. Delay in diagnosis and referral from various centers was apparent as 23 cases (69.7%) presented beyond three days of onset of symptoms. Manual operative reduction was possible in 50% of cases who presented beyond 5 days of onset of symptoms. There was one unusual case of post operative jejuno-jejunal intussusception after an initial operative manual reduction of ileo-colic intussusception. 36% of the patients that presented more than 72hours after the onset of symptoms required bowel resections, on account of vascular compromise of the intussusception. Yet there was no mortality in this series. Late presentation
of patients with intussusception is still quite common in our environment, increasing complications in these cases. However by a combination of aggressive fluid resuscitation and close monitoring prior to surgery, we have been able to manage these cases and achieve good results.
management. The commonest type was ileo-colic intussusception (91%). There was no definite pathologic lead point but enlarged Peyer’s patches were noticed in 5 cases. Delay in diagnosis and referral from various centers was apparent as 23 cases (69.7%) presented beyond three days of onset of symptoms. Manual operative reduction was possible in 50% of cases who presented beyond 5 days of onset of symptoms. There was one unusual case of post operative jejuno-jejunal intussusception after an initial operative manual reduction of ileo-colic intussusception. 36% of the patients that presented more than 72hours after the onset of symptoms required bowel resections, on account of vascular compromise of the intussusception. Yet there was no mortality in this series. Late presentation
of patients with intussusception is still quite common in our environment, increasing complications in these cases. However by a combination of aggressive fluid resuscitation and close monitoring prior to surgery, we have been able to manage these cases and achieve good results.
