Background: Intussusception remains a common cause of intestinal obstruction in infants and children. The operative treatment remains the main stay of treatment due to late presentation, long referral chain, paucity of knowledge about the disease condition by midwife and doctors. This study is intended to ascertain the pattern of presentation, management and outcome. Method: This is a prospective study of 48 children that was managed for intussusceptions at the Abia State University Teaching Hospital from November 2016 t0 November 2018. Structured proforma was opened for demography, clinical presentation, investigation, treatment modalities and outcome. Data was analysed using SPSS version 17 for proportions and percentages. Results: There were 24 boys and 24 girls aged 3 months to 13 months with a mean of 8months. The median duration of symptoms onset and presentation was 4 days {1 day to 14days}. Thirty-six patients {75%} presented after 48hours of onset of symptoms. A classic triad {bilious vomiting, bloody mucoid stool and abdominal mass} was present in over 40 patients {83%}. Ten patients did not pass bloody mucoid stool. Thirty patients {62.5%} had predisposing factors which included gastroenteritis and/or respiratory tract infection. 8 patients had hydrostatic saline reduction under ultrasound with success in six patients. Forty-two patients were operated {40 patients primarily and 2 patients following failed hydrostatic reduction}. Twenty-eight patients had resection and anatomises of ileocolic segment due to gangrenous bowel. Fourteen patients had manual reduction of intussuception with healthy bowel. Mortality was 8.3% {4 patients} from overwhelming sepsis and respiratory distress. Twenty patients had surgical site infection and 4 patients had incisional hernias. Conclusion: Late presentation was high in this series, however, emphasis on health education of mothers during antenatal visit that passage bloody mucoid stool by their child needs evaluation by a paediatrician will reduce late presentation morbidity and mortality in our patients.
| Published in | American Journal of Pediatrics (Volume 5, Issue 1) |
| DOI | 10.11648/j.ajp.20190501.14 |
| Page(s) | 18-21 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Intussusceptions, Under-Five Children, Evaluation
| [1] | Shally Awasthi, Girdhar G Agarwal, Vikas Mishra, Vijay Laxmi Nag. Four-country surveillance of intestinal intussusception and diarrhoea in children. Journal of Paediatrics and Child Health. 2009: 45; 82–8. |
| [2] | Tate JE, Mweda JM, Armah B, Jani B. Evaluation of Intussusception after Monovalent Rotavirus Vaccination in Africa. N Engl J Med 2018; 378: 1521-8. |
| [3] | Atalabi, OM, Ogundoyin, OO, Ogunlana, DI, Onasanya, OM, Lawal, TA, Olarinoye, AS. Hydrostatic reduction of intussusception under ultrasound guidance: An initial experience in a developing country. Afr J Paediatr Surg 2007; 4 (2): 68–71. |
| [4] | Ekenze SO, Mgbor SO Childhood intussusception: the implications of delayed presentation. Afr J Paediatr Surg 2011 8: 15–18. |
| [5] | Archibong AE, Usoro IN, Ikpi E, Inyang A (2001) Paediatric intussusception in Calabar, Nigeria. East Afr Med J 78: 19–21. 15. |
| [6] | Bode CO Presentation and management outcome of childhood intussusception in Lagos: a prospective study. Afr J Paediatr Surg2008 5: 24–28. 16. |
| [7] | HO, W. L., Yang, T. W., Chi, W. C., Chang, H. J., Huang, L. M. and Chang, M. H. Intussusception in Taiwanese Children: Analysis of Incidence, Length of Hospitalization and Hospital Costs in Different Age Groups. Journal of the Formosan Medical Association, 2005: 104, 398-40. |
| [8] | Lai AH, Phua KB, Teo EL Jacobsen AS. Intussusception: a three-year review. Ann Acad Med Singapore 2002: 31; 81–85. |
| [9] | Crankson SJ, Al-Rabeeah AA, Fischer JD, Al-JadaanSA, NamshanMA. Idiopathic intussusception in infancy and childhood. Saudi Med J 2003: 24; S18–S20. |
| [10] | Tagbo, B. N., Mwenda, J. M., Armaha, Obidike, E. O., Okafor, H. U., Oguonu, T., et al. Epidemiology of Rotavirus Diarrhoea among Children Younger than 5 Years in Enugu, South East Nigeria. Pediatric Infectious Disease Journal. 2014: 33; S19-S22. |
| [11] | Ameh EA The morbidity and mortality of laparotomy for uncomplicated intussusception in children. West Afr J Med2002: 21; 115–116. |
| [12] | Carneiro PM, Kisusi DM Intussusception in children seen at Muhimbili National Hospital, Dar es Salaam. East Afr Med J 2004: 81; 439–442. |
| [13] | Ameh EA The morbidity and mortality of right hemicolectomy for complicated intussusception in infants. Niger Postgrad Med J 2002: 9; 123–124. |
| [14] | Adejuigbe, O., Jeje, E. A. and Owa, J. A. Childhood Intussusception in Ile-Ife, Nigeria. Annals of Tropical Paediatrics International Child Health. 1991: 11; 123-12. |
| [15] | Beckie Nnenna Tagbo, Jason Mwenda, Christopher Eke, Tagbo Oguonu Sebastin Ekenze. Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria. World Journal of Vaccines. 2014: 4; 123-132. |
| [16] | Stringer MD, Capps SW, Pablot SM. Sonographic detection of the lead point in intussusception. Arch Dis Child 1992: 67; 529-530. |
| [17] | Pracros JP, Tran-Minh VA, Morin DE, et al. Acute intestinal intussusception in children: contribution of ultrasonography (145 cases). Ann Radiol 1987: 30; 525-530. |
| [18] | Ogubdoyin OO, Atalabt OM, Lawal TA, Olulana DI. Experience With Sonogram-Guided Hydrostatic Reduction of Intussusception in Children in South-West Nigeria JWACS 2013: 3; 2, 4-6. |
APA Style
Samuel Chidi Ekpemo, Emeka Nkwo. (2019). Evaluation of Intussusceptions in Under - Five Children in Aba Nigeria. American Journal of Pediatrics, 5(1), 18-21. https://doi.org/10.11648/j.ajp.20190501.14
ACS Style
Samuel Chidi Ekpemo; Emeka Nkwo. Evaluation of Intussusceptions in Under - Five Children in Aba Nigeria. Am. J. Pediatr. 2019, 5(1), 18-21. doi: 10.11648/j.ajp.20190501.14
AMA Style
Samuel Chidi Ekpemo, Emeka Nkwo. Evaluation of Intussusceptions in Under - Five Children in Aba Nigeria. Am J Pediatr. 2019;5(1):18-21. doi: 10.11648/j.ajp.20190501.14
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ajp.20190501.14,
author = {Samuel Chidi Ekpemo and Emeka Nkwo},
title = {Evaluation of Intussusceptions in Under - Five Children in Aba Nigeria},
journal = {American Journal of Pediatrics},
volume = {5},
number = {1},
pages = {18-21},
doi = {10.11648/j.ajp.20190501.14},
url = {https://doi.org/10.11648/j.ajp.20190501.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190501.14},
abstract = {Background: Intussusception remains a common cause of intestinal obstruction in infants and children. The operative treatment remains the main stay of treatment due to late presentation, long referral chain, paucity of knowledge about the disease condition by midwife and doctors. This study is intended to ascertain the pattern of presentation, management and outcome. Method: This is a prospective study of 48 children that was managed for intussusceptions at the Abia State University Teaching Hospital from November 2016 t0 November 2018. Structured proforma was opened for demography, clinical presentation, investigation, treatment modalities and outcome. Data was analysed using SPSS version 17 for proportions and percentages. Results: There were 24 boys and 24 girls aged 3 months to 13 months with a mean of 8months. The median duration of symptoms onset and presentation was 4 days {1 day to 14days}. Thirty-six patients {75%} presented after 48hours of onset of symptoms. A classic triad {bilious vomiting, bloody mucoid stool and abdominal mass} was present in over 40 patients {83%}. Ten patients did not pass bloody mucoid stool. Thirty patients {62.5%} had predisposing factors which included gastroenteritis and/or respiratory tract infection. 8 patients had hydrostatic saline reduction under ultrasound with success in six patients. Forty-two patients were operated {40 patients primarily and 2 patients following failed hydrostatic reduction}. Twenty-eight patients had resection and anatomises of ileocolic segment due to gangrenous bowel. Fourteen patients had manual reduction of intussuception with healthy bowel. Mortality was 8.3% {4 patients} from overwhelming sepsis and respiratory distress. Twenty patients had surgical site infection and 4 patients had incisional hernias. Conclusion: Late presentation was high in this series, however, emphasis on health education of mothers during antenatal visit that passage bloody mucoid stool by their child needs evaluation by a paediatrician will reduce late presentation morbidity and mortality in our patients.},
year = {2019}
}
TY - JOUR
T1 - Evaluation of Intussusceptions in Under - Five Children in Aba Nigeria
AU - Samuel Chidi Ekpemo
AU - Emeka Nkwo
Y1 - 2019/03/11
PY - 2019
N1 - https://doi.org/10.11648/j.ajp.20190501.14
DO - 10.11648/j.ajp.20190501.14
T2 - American Journal of Pediatrics
JF - American Journal of Pediatrics
JO - American Journal of Pediatrics
SP - 18
EP - 21
PB - Science Publishing Group
SN - 2472-0909
UR - https://doi.org/10.11648/j.ajp.20190501.14
AB - Background: Intussusception remains a common cause of intestinal obstruction in infants and children. The operative treatment remains the main stay of treatment due to late presentation, long referral chain, paucity of knowledge about the disease condition by midwife and doctors. This study is intended to ascertain the pattern of presentation, management and outcome. Method: This is a prospective study of 48 children that was managed for intussusceptions at the Abia State University Teaching Hospital from November 2016 t0 November 2018. Structured proforma was opened for demography, clinical presentation, investigation, treatment modalities and outcome. Data was analysed using SPSS version 17 for proportions and percentages. Results: There were 24 boys and 24 girls aged 3 months to 13 months with a mean of 8months. The median duration of symptoms onset and presentation was 4 days {1 day to 14days}. Thirty-six patients {75%} presented after 48hours of onset of symptoms. A classic triad {bilious vomiting, bloody mucoid stool and abdominal mass} was present in over 40 patients {83%}. Ten patients did not pass bloody mucoid stool. Thirty patients {62.5%} had predisposing factors which included gastroenteritis and/or respiratory tract infection. 8 patients had hydrostatic saline reduction under ultrasound with success in six patients. Forty-two patients were operated {40 patients primarily and 2 patients following failed hydrostatic reduction}. Twenty-eight patients had resection and anatomises of ileocolic segment due to gangrenous bowel. Fourteen patients had manual reduction of intussuception with healthy bowel. Mortality was 8.3% {4 patients} from overwhelming sepsis and respiratory distress. Twenty patients had surgical site infection and 4 patients had incisional hernias. Conclusion: Late presentation was high in this series, however, emphasis on health education of mothers during antenatal visit that passage bloody mucoid stool by their child needs evaluation by a paediatrician will reduce late presentation morbidity and mortality in our patients.
VL - 5
IS - 1
ER -
Information
Email: