Clinico-pathological features of intussusception in children beyond five years old.

Wen-Pin Lai, Yao-Jong Yang, Chao-Neng Cheng, Jiann‐Shiuh Chen
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引用次数: 2

Abstract

BACKGROUND The pathoetiology and outcomes of intussusception in older children are different from those in young children. This study aims to investigate the characteristics and outcomes of intussusception in children older than 5 years in a tertiary referring hospital. METHODS A retrospective review of patients aged older than five years having received a postoperative or roentgenographic diagnosis of intussusception between 1988 and 2005 was conducted. The clinical presentations, diagnostic and treatment methods, and outcomes of all cases were reviewed. RESULTS A total of 12 cases were recorded. They were eight males and four females, with a median age of 7.6 years (range 5.0-11.1 years). Four (33.3%) children had symptoms lasting more than one week before a prompt diagnosis was made. The most commonly encountered symptom was abdominal pain (100%), followed by nausea/vomiting (75.0%). Recurrent intussusception occurred in 33% of cases. Abdominal sonogram identified intussusceptum in all patients when this procedure was performed. Six patients were treated operatively. Lead lesions including two malignant lymphomas, one Meckel diverticulum, and one colon polyp were found in 4 cases. Three of the four lead points were diagnosed and treated by colonoscopy preoperatively. Complications after operations were adhesive ileus (33.3%) and recurrent intussusception (16.7%). All patients remained well, including those who had lead points identified after prompt treatments. CONCLUSIONS Intussusception in older children presents a higher frequency of persistent symptoms, lead points, and recurrence. Pediatricians need to be aware of the etiology and treatment options for intussusception in older children.
5岁以上儿童肠套叠的临床病理特征。
背景:大龄儿童肠套叠的病因和结局不同于幼儿。本研究旨在探讨一家三级转诊医院5岁以上儿童肠套叠的特点和结局。方法回顾性分析1988年至2005年间接受肠套叠术后或x线片诊断的年龄大于5岁的患者。回顾所有病例的临床表现、诊断和治疗方法及结果。结果共记录12例。男性8例,女性4例,中位年龄7.6岁(范围5.0-11.1岁)。4名(33.3%)儿童在及时诊断前症状持续超过一周。最常见的症状是腹痛(100%),其次是恶心/呕吐(75.0%)。33%的病例发生复发性肠套叠。腹部超声检查发现所有患者都有肠套叠。6例患者行手术治疗。4例发现恶性淋巴瘤2例,梅克尔憩室1例,结肠息肉1例。术前结肠镜检查诊断和治疗4个导点中的3个。术后并发症为粘连性肠梗阻(33.3%)和复发性肠套叠(16.7%)。所有患者都保持良好,包括那些在及时治疗后确定了铅点的患者。结论大龄儿童存在持续性症状、导点和复发率较高。儿科医生需要了解大龄儿童肠套叠的病因和治疗方案。
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