The morbidity and mortality of laparotomy for uncomplicated intussusception in children.
Non-operative management by pressure reduction is now the preferred treatment for uncomplicated intussusception in children. However, in many developing countries, laparotomy is routinely performed for such cases. This is a retrospective anlaysis of 24 children who had operative reduction of intussusception. The age range was 3 months--10 years (median 7 months) and duration of symptoms 12 hours--7 days (median 2 days). The main features were abdominal pain, vomiting and rectal bleeding. Ten (42%) patients had varying degrees of dehydration, which were corrected. At laparotomy, the intussusceptions were reduced without difficulty. Thirteen (54%) patients developed 15 procedure related complications including wound infection 6(25%), ileus 2(8%), stitch sinus 2(8%), incisional hernia 2(8%), intestinal obstruction from adhesions resulting in intestinal gangrene 2(8%) and aspiration pneumonia 1 (4%). Mortality was 2( 8%) from aspiration pneumonia and overwhelming infection due to intestinal gangrene from adhesive intestinal obstruction respectively. Laparotomy for uncomplicated intussusception in children is attended by significant morbidity and mortality. Many of such intususceptions, may be successfully managed by pressure reduction and children should not be denied the benefits of this form of treatment.
Ameh
Emmanuel A
EA
Department of Surgery Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003108:Colonic Diseases / Q000601:surgery*; D003906:Developing Countries; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000601:surgery*; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology; D007418:Intestinal Pseudo-Obstruction / Q000453:epidemiology / Q000209:etiology; D007443:Intussusception / Q000601:surgery*; D007813:Laparotomy / Q000009:adverse effects* / Q000401:mortality*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009017:Morbidity; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D015996:Survival Rate