Abstract
Objectives The primary objective of this study was to analyze and review the demographics of
children operated upon for intussusception. Secondary objectives were to review the
clinical characteristics, surgical procedures performed, postoperative complications,
and outcome.
Materials and Methods It is a single-institution, retrospective study and consists of children below the
age of 12 years. This study was conducted at the author’s department of pediatric
surgery for the past 21 years, from January 1, 2000 to December 31, 2020.
Results During the study period, 212 children were operated upon for intussusceptions and
included 146 (68.86%) boys and 66 (31.13%) girls. This review consisted of infants
158 (74.52%), and children of 1 to 5 years of age (30; 14.15%), and 6 to 12 years
of age (24; 11.32%). Clinically, 177 (83.49%) children presented with the features
of acute intestinal obstruction, and the remaining 35 (16.5%) presented with features
of perforation peritonitis. Primary (idiopathic) intussusception was documented in
188 (88.67%) of the cases. Gangrenous bowel was evident in 98 (46.22%) children. Sixty-two
percent of the cases required bowel resection. Surgical procedures were executed in
children for intussusception in the following order of frequency: (1) operative reduction
with or without serosal tear/bowel perforation repair, n = 81 (38.2%); (2) resection of diseased ileum and ileoileal anastomosis, n = 52 (24.52%); (3) resection of diseased ileum ± part of colon and an ileostomy,
n = 36 (16.98%); and (4) resection of diseased ileum, cecum, part of colon, and ileocolic
(ileo-ascending or ileo-transverse) anastomosis, n = 43 (20.28%). Postoperatively, 9 (4.24%) children required reexploration for the
management of their complications. Twenty-one (9.9%) children died during the postoperative
period.
Conclusion Intussusception remains the most common cause of acute intestinal obstruction in
infants and young children. Delay in the referral, diagnosis, and seeking treatment
were significantly associated with bowel gangrene, required bowel resection during
the surgical therapy, and also culminated in significantly higher mortalities.
Keywords
children - infant - intestinal obstruction - intussusception - bowel gangrene - pathological
lead point
