title: Clinical features and treatment outcome of intussusception in premature neonates.
abstract: OBJECTIVE
  Less than 1.3% of all cases of intussusception occur in term neonates. Intussusception in premature neonates (IPN) is exceedingly rare. Its rarity and difficulty to differentiate IPN from common neonatal diseases like necrotizing enterocolitis (NEC) often delays its diagnosis. The authors set out to characterize diagnosis, treatment, and outcome of this rare condition.
  
  
  METHODS
  The authors analyzed 2 new cases of IPN and 33 previously reported cases from the literature.
  
  
  RESULTS
  The 35 patients with IPN had an average gestational age, postconceptual age at diagnosis, and birth weight of 28.4 +/- 0.6 weeks (all data, mean +/- SEM), 31.1 +/- 0.5 weeks, and 1,165 +/- 21 g, respectively. Gastrointestinal symptoms first presented at age 8 +/- 1 days. A preoperative diagnosis of NEC was assumed in 24 patients, delaying diagnosis by 10 +/- 2 days. Intussusception was diagnosed radiographically in 2 patients (1 contrast enema and 1 ultrasound scan) and during surgery or autopsy in the remainder. Resection was reported in 28 patients for bowel that was irreducible, necrotic, or perforated. The overall mortality rate was 20%, mainly owing to sepsis.
  
  
  CONCLUSIONS
  Intussusception in the premature neonate often is misdiagnosed as NEC, delaying operative intervention. Contrast enema has limited diagnostic capability. Early diagnosis may be achieved with use of ultrasound scan. Intussusception can be treated successfully with resection and primary anastomosis, achieving good results.
authors.affiliation: Department of Surgery, University of Washington, Seattle, WA 98195, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Avansino
authors.forename: Scott
authors.initials: S
authors.lastname: Bjerke
authors.forename: Margo
authors.initials: M
authors.lastname: Hendrickson
authors.forename: Matthias
authors.initials: M
authors.lastname: Stelzner
authors.forename: Robert
authors.initials: R
authors.lastname: Sawin
mesh_terms: D001466:Barium Sulfate; D003937:Diagnosis, Differential; D004733:Enema; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000601:surgery*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000601:surgery*; D019102:Infant, Very Low Birth Weight; D007443:Intussusception / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D016896:Treatment Outcome
chemical_list: D001466:Barium Sulfate