Clinical and paraclinical differences between pediatric patients requiring surgical versus Non-Surgical treatment for intussusception: A retrospective study at a referral center in Iran.

Abstract

Background: Intussusception is a common cause of bowel obstruction in children, often requiring prompt intervention to prevent complications. While non-surgical reduction is the preferred treatment, some patients require surgical management. Identifying factors associated with the need for surgery is essential to optimize patient outcomes. This study aimed to examine the clinical and paraclinical differences between pediatric patients who received surgical versus non-surgical treatment for intussusception.

Methods: This retrospective study reviewed the medical records of pediatric patients diagnosed with intussusception at the Children's Medical Center, Tehran, Iran, between April 2018 and March 2020. Out of 571 pediatric patients diagnosed with intussusception, 165 were included in the analysis-55 who underwent surgery and 110 who were treated non-surgically. Demographic, clinical, and laboratory data were analyzed to identify factors influencing surgical intervention. Statistical analyses were performed using independent t-tests, chi-square tests, and Fisher's exact tests, with significance set at P < 0.05.

Results: Patients who underwent surgery were significantly younger than those treated non-surgically (2.68 ± 1.65 vs. 3.88 ± 3.51 years; P < 0.001), with a higher proportion of cases under one year of age (P = 0.004). Laboratory parameters, including white blood cell count (P = 0.53), erythrocyte sedimentation rate (P = 0.69), and C-reactive protein levels (P = 0.55), did not differ significantly between the groups. Among clinical symptoms, the presence of bloody stools was significantly associated with surgical intervention (P < 0.001). Sonographic findings showed that ileocolic intussusception was more common in the surgical group (P < 0.001).

Conclusion: Younger age, the presence of bloody stools, and ileocolic intussusception were associated with a higher likelihood of surgical reduction in pediatric intussusception. Recognizing these risk factors may facilitate early diagnosis and support better treatment decision-making.