Purpose
Intussusception is the commonest cause of acute bowel obstruction in children and if left untreated may progress rapidly to sepsis and patient death.
The telescoping of bowel into itself is most eloquently explained by the illustration in Figure 1
The mechanism of intussusception is thought to be due to hypertrophy of lymphoid tissue in the small bowel wall,
and occasionally pathological lead points are identified.
Pathological lead points are found in 5-10% of cases and include Meckel’s diverticulum,
polyp,
lymphosarcoma,
duplication cyst or Henoch Schoenlein...
Methods and Materials
Cases were identified from radiology information systems (RIS) and patient data was obtained using both RIS and picture archiving and communication systems (PACS).
In the cases of incomplete data and in cases of failed reduction,
patient charts were reviewed.
Data was compiled on Microsoft Excel software on which basic analysis was performed.
Fisher’s exact test was used to compare the differences in outcomes amongst patient groups.
Statistical analysis was performed on Graphpad Prism 5.
Results
During our study period,
there were 85 intussusceptions diagnosed in children in Northern Ireland.
These children all underwent attempted radiological reduction.
As expected,
the majority of these children were male,
with 60 boys,
compared to 25 girls (71%/29% split).
We achieved a success rate of 78.8% (n=67),
with a negative outcome in n=1 (1.2%).
The age profile of our patients is,
unsurprisingly,
in keeping with international data,
the median age 8months (mean 1yr 4months,
range 1 day- 14.5 yrs).
64% (n=53) of the patients were...
Conclusion
Success rates of greated than70%recommended by the Royal College of Radiologists in London [10],and our data show that oursuccess rate(78.8%)meets with acceptable national standards.
We realise that our current standards date from 1999 and we must strive to ensure that our practice remains up to date,
and keeps pace with improvements in patient care elsewhere in the field of clinical paediatric medicine.
We highlight the clinical and radiological features that may help predict those cases where pneumatic reduction will not be successful,
however it is...
References
Grainger and Allison’s Diagnostic Radiology.
5th Edition (2008):Vol 2.
Section 8.
Chapter 65.
Paediatric Abdominal Imaging.
Paterson A,
Sweeney L E,
Connolly B.
Churchill Livingstone Publishers.
Philadelphia.
Waseem M,
Rosenberg HK: Intussusception.
Pediatric emergency care 2008,
24(11):793-800.
Samad L,
Marven S,
El Bashir H,
Sutcliffe AG,
Cameron JC,
Lynn R,
Taylor B: Prospective surveillance study of the management of intussusception in UK and Irish infants.
The British journal of surgery 2012,
99(3):411-415.
Stringer MD,
Willetts IE: John Hunter,
Frederick Treves and intussusception.
Annals of the...
Personal Information
NickClarke,
MB,
MCh,
MRCSI
Radiology Registrar
Annie Paterson,
MB,
BS,
MRCP,
FRCR,
FFRRCSI
Consultant Paediatric Radiologist