Risk Factors for Surgical Procedure on Ileo-Colic Intussusception in Children

Purpose: The aim of this study was to analyze of the risk factors for surgical procedure on ileo-colic intussusception without leading point in children. Methods: We retrospectively reviewed medical records of patient treated for ileo-colic intussusception between January 2003 and December 2014. We exclude the patients who had leading point. Because of the large difference on patient’s numbers between non-operative group (cases of ileo-colic intussusceptions successfully reduced by air reduction) and operative group (cases underwent operation due to failed air reduction), we compared the data of operative group of patients without leading point between 2003 and 2014 with the data of non-operative group as control group from 2013 to 2014. Clinical features such as gender, age, body temperature, body weight in diagnosis, growth curves for age-gender-body weight, and laboratory data of blood test were compared. Results: In non-operative group, total 94 patients who were treated successfully by the non-operative air reduction. In operative group, total 21 patients treated by surgical procedure. The age under 12 months, weight over upper 75 percentile group, increased segment neutrophil count, decreased hemoglobin level and lymphocyte count were significantly associated with a requirement for surgical procedure. Conclusion: We conclude that younger age, higher weight percentile group, increased segment neutrophil, decreased hemoglobin and lymphocyte are the independent risk factors related to operative treatment for ileo-colic intussusception in children. If primary air reduction is failed in patients with such risk factors, operative treatment over ultrasonography or secondary reduction can prevent unnecessary effort and complications, thus emphasizing the consideration of operative treatment when selecting treatment methods.