Management of Pediatric Intussusception: Review of the Treatment Algorithm (Retrospective Study)

Abstract

Objective: In large series, the clinical features, management steps, and treatment results of intussusceptions have been studied. Material and Methods: Retrospective study including intussusception patients in a single center between 2008-2021. Results: There were 406 patients: 353 (86.9%) patients with ileocolic, 30 (7.4%) patients with small bowel, and 23 (5.7%) patients colocolic intussusception. In small bowel intussusceptions, 60% (18/30) of patients were treated surgically and in 40% (12/30) spontaneous reduction happened. Pathological lead points (PLPs) were found in 23.3% (7/30) of patients. In colocolic intussusception, the nonoperative reduction was used in 22/23 patients with a 90.9% success rate. The rate of PLPs was 4.3% (1/23). In ileocolic intussusception, spontaneous reduction happened in 18% (64/353) of cases. Nonoperative reduction was used as initial treatment in 272/353 patients with 79% (215/272) success rate and surgical management was used in 22.2% (78/353) of patients. The recurrence rate was 17.2% (61/353) with 85 attacks. Nonoperative reduction was used in 65/85 of attacks with 93% success rate. PLPs rate in different age groups was: 3.8% (0-2 years), 8% (2-5 years) and 17.4% (>5 years) (p value5 years old the frequency of Burkitt lymphoma was remarkable 10.8%. Conclusion: Although the first-line approach in small bowel intussusceptions is surgical exploration, the frequency of spontaneous reduction is high in cases with short segments (5 years old with ileocolic intussusceptions because of the high incidence of PLPs and Burkitt's lymphoma.