[Management of intussusception in France in 2004: investigation of the Paediatric Infectious Diseases Group, the French Group of Paediatric Emergency and Reanimation, and the French Society of Paediatric Surgery].
OBJECTIVE
To describe the different pathways of management of intussusception (IS) in infants and children in metropolitan France and to identify paediatric emergency centres that might constitute a surveillance network for IS.


METHODS
A questionnaire was sent to 273 paediatric emergency centres distributed across France in 2005. Modalities of diagnosis and treatment of IS had to be precised.


RESULTS
One hundred and sixty-seven centres (61.2%) responded. The response was given by 131 paediatricians (78.4%) and 36 surgeons (21.6%) working in 38 universitary hospitals (22.7%) and 129 general hospitals (77.2%). The mean number of IS treated in each centre in 2004 was 11+/-13.5 (extr. 0 to 70; median 6). Diagnosis of IS required a collaboration between medical and surgical teams in 51.5% of the centres, but in 40.1% the sole medical team was in charge of the diagnosis. Ultrasonography is used for diagnosis by 98.8% of the centres. Reduction with hydrostatic enema and eventually surgery was performed in the same hospital in 44.3%. Other centres systematically or frequently transferred the patients for reduction, mostly towards universitary hospitals (90%).


CONCLUSIONS
The procedures of IS diagnosis are the same everywhere in France but the pathways of therapeutic management do vary, depending on the availability of surgeons and anaesthetists trained in paediatrics on each site. These disparities will probably change with the implementation of the new plan for sanitary organization in children and adolescents in France. Labellized paediatric emergency centres will gather more surgical patients and could eventually constitute an effective surveillance network for IS.
Grimprel
E
E
Service de Pédiatrie, Hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France. emmanuel.grimprel@trs.aphp.fr
de La Rocque
F
F
Romain
O
O
Minodier
P
P
Dommergues
M-A
MA
Laporte-Turpin
E
E
Lorrot
M
M
Parez
N
N
Caulin
E
E
Robert
M
M
Lehors
H
H
Chéron
G
G
Levy
C
C
Haas
H
H
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D004636:Emergency Service, Hospital; D004733:Enema / Q000379:methods; D005602:France; D006769:Hospitals, General; D006785:Hospitals, University; D006801:Humans; D007443:Intussusception / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D010360:Patient Transfer; D010372:Pediatrics / Q000639:trends*; D011795:Surveys and Questionnaires; D014463:Ultrasonography