Clinical outcomes of intussusception: The experience in Johannesburg, South Africa

Abstract

Background. A previous study on intussusception from our institution demonstrated a pneumatic reduction (PR) rate of 33%, witha mortality rate of 9.1%. Numerous protocol changes were implemented, and as part of a national prospective observational study, asubsequent cohort of patients was compared with the initial series.Objectives. To compare our current series of children presenting with intussusception with our previous series. Specifically, we aimed tocompare PR rates, resection rates, morbidity and mortality.Methods. This was a retrospective review of patients aged <3 years who presented with intussusception to Chris Hani BaragwanathAcademic Hospital in Johannesburg, South Africa, from 2011 to 2015 (era 2). Clinical outcomes of patients and management modalitieswere reviewed. These were compared with results reported in the previous article (2007 - 2010, era 1).Results. A total of 111 patients were included. PR was attempted in 52 patients (46.8%). It was successful in 25 patients (48.1%) andunsuccessful in 27 (51.9%), with an overall success rate of 22.5%. Eighty-six patients (77.5%) underwent surgical intervention. Bowelresection was performed in 54/86 of the surgically managed patients. No deaths were reported during the era 2 study period.Conclusion. Despite improved protocols, we could not demonstrate an improvement in the proportion of attempted PR cases comparedwith our previous series, and we did not achieve better PR rates. This failure is thought to be due to the delayed presentation of our patients,as well as an aggressive approach to management. However, this aggressive management strategy has decreased our mortality rate to zero.