Intussusception in the 1990s: has 25 years made a difference?
To evaluate the current management of the infant and child with intussusception, the medical records of 188 consecutive intussusception patients over 5 years (1985-1990) were reviewed and compared to our series from 25 years ago (1959-1968). The peak months changed from May and June to January and July. Duration of symptoms and signs prior to diagnosis increased by one-third to 35 h with, however, a decrease in the incidence of pain, vomiting, abdominal mass, and rectal blood. Air was the only contrast used for the hydrostatic enema in the present series and was tried in every case with 81% success; this is a major improvement from 45% in the old series. There were three perforations (1.4%) with air-enema attempts compared with 1 (0.2%) 25 years ago. Recently only 19% of patients required operation but 30% needed resection; 55% of the patients in the older series required operation and 20% needed resection. Ten percent of intussusceptions continue to be found spontaneously reduced at operation. There were many less pathologic lead points in the newer series. The recurrences increased from 4% to 7%, but their reduction rate also increased from 31% with barium to 100% with air. There were no deaths in the last 25 years.
Ein
S H
SH
Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8.
Alton
D
D
Palder
S B
SB
Shandling
B
B
Stringer
D
D
D001466:Barium Sulfate / Q000627:therapeutic use; D004733:Enema; D005260:Female; D005762:Gastroenterology / Q000639:trends*; D006801:Humans; D006874:Hydrostatic Pressure; D007077:Ileal Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D007223:Infant; D007443:Intussusception / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies
D001466:Barium Sulfate