Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center

Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130 ± 175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction ( p =0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel’s diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7 ± 1.9 in 7 patients with PLP, which was significantly higher than (2.4 ± 0.9) patients without a PLP ( p =0.023). The mean duration of recurrences was 17.4 ± 19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times. (Korean J Pediatr Gastroenterol Nutr 2009; 12: 163 ∼ 170)