PATTERNS AND SEASONAL VARIATION OF INTUSSUSCEPTION IN CHILDREN: A RETROSPECTIVE ANALYSIS OF CASES OPERATED IN A TERTIARY HOSPITAL IN ETHIOPIA.

Anteneh Gadisa Belachew | Bio
Hawassa University, College of Health Sciences
Amezene Tadesse | Bio
Department of Surgery, School of Medicine , Addis Ababa University
Berhanu Hailemariam Bogale | Bio
Department of Surgery, School of Medicine, Addis Ababa University
Share:
  • Articles
  • Submited: August 14, 2015
  • Published: January 14, 2016

Abstract

 

Background: Intussusception is one of the frequent causes of  bowel  obstruction  in  infants  and toddlers(1). It involves invagination of a portion of intestine into another(2–4). The peak age of occurrence is between the age of 4 and 8 months. The aim of this study is to review the pattern of clinical presentation and seasonal variation of intussusception in our hospital, and to analyze the mode and outcomes of treatment.

Patients and Methods: This is a four-year retrospective study of children aged 13 years and below who were admitted and treated for intussusception between January 2011 and December 2014 at the pediatric surgery unit of Tikur Anbesa Specialized Hospital (TAH) in Ethiopia. Information on the patients’ demographic characteristics, clinical presentation, and month of occurrence as well as the operative findings and outcome were obtained from the pediatric surgery unit record book, patient charts, and the operating theatre registry.

Results: One hundred and thirty six cases of intussusception were admitted to TAH, Addis Ababa over a four year period, of which 130 charts were retrieved and analyzed. Males dominated in the series. Age distribution showed that 59.2% of the cases were <one year old, and 77.7 % were <two years old. Abdominal pain, vomiting, bloody mucoid diarrhea and a mass palpated abdominally and/or rectally were the most common  modes of presentations, with the classic triad of abdominal pain, vomiting and bloody mucoid diarrhea occurring in nearly two third of cases. The highest peak of presentation was in the month of June with 18 (13.9%) cases. The mean duration of symptoms before presentation to our hospital was 5.2 days with a range of 1-21 days. Intraoperatively, it was found that ileocolic intussusception was the most common type. Simple reduction without bowel resection was possible in 70.8% of cases. There were 44(33.9 %) complications, wound site infection being the most common  occurring in 20 (15.4 %) cases and there were 6 deaths.

Conclusion: Intussusception was more common in the wet season. There was delayed presentation with a higher rate of operative management and bowel resection. The mortality rate has decreased significantly compared with a previous study from this institution.

Keywords: Intussusception, seasonal variation, Children, TAH

 

Downloads

Download data is not yet available.

References

  1. Ignacio, Jr RC, Fallat ME. INTUSSUSCEPTION. Ashcraft’s Pediatric Surgery. 5th ed. Philadelpia, USA: Elsevier Inc.; 2010. p. 508–16.
  2. Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood Intussusception: A Literature Review [Internet]. PLoS ONE. 2013 [cited 2014 May 31].
  3. Chalya P, Kayange N, Chandika A. Childhood intussusceptions at a tertiary care hospital in northwestern Tanzania: a diagnostic and therapeutic challenge in resource-limited setting. Italian Journal of Pediatrics [Internet]. 2014 [cited 2014 May 29];40(28).
  4. Bode C. Presentation and management outcome of childhood intussusception in Lagos: A prospective study. Afr J Paediatr Surg. 2008;5(1):24–8.
  5. Ekenze SO, Mgbor SO. Childhood intussusception: The implications of delayed presentation. Afr J Paediatr Surg. 2011 Apr;8(1):15–8.
  6. Talabi AO, Sowande OA, Etonyeaku CA, Adejuyigbe O. Childhood intussusception in Ile-ife: What has changed? Afr J Paediatr Surg. 239AD 242;10(3):239–42.
  7. Lapitov R, Khudoyorov R, Flen E. Childhood intussusception in Uzbekistan: Analysis of retrospective surveilance data [Internet]. BioMed Cental. 2011[cited 2014 May 31]. Available from: http://www.biomedcentral.com
  8. Usang UE, Inah GB, Inyang AW, Ekabua AT. Intussusception in children: Comparison between ultrasound diagnosis and operation findings in a tropical developing country. Afr J Paediatr Surg. 2013;10(2):87–90.
  9. Gudeta B. Intussusception in children: a ten year review. East African Medical Journal. 1993;70(11):730–1.
  10. Shakya VC, Agrawal CS, Sinha AK, Bhatta NK, Khania S, Adhikary S. Childhood Intussusception: A Prospective Institutional Study at BPKIHS. J. Nepal Paediatr Soc. 2011 Apr;31(1):6–10.
  11. Ekenze SO, Mgbor SO, Okwesili OR. Routine surgical intervention for childhood intussusception in a developing country. A. 2010;9(1):27–30.
  12. Ameh E. The morbidity and mortality of right hemicolectomy for complicated intussusception in infants. Niger Postgrad Med J. 2002 Sep;9(3):123–4.
  13. Carneiro PM, Kisusi DM. Intussusception in children seen at Muhinbili Hospital, Dar Es Salaam. East Afr Med J. 2004 Sep;81(9):439–42.
  14. Davis CF, McCabe AJ, Raine PAM. The Ins and Outs of Intussusception: History and Management Over the Past Fifty Years. J. Pediatr. Surg. 38(7):60–4.
  15. Singh S, Wakhlu A, Rawat J. Delayed presentation of Intussusception in children- a surgical audit. Annals of Pediatric Surgery. 2011;7:130–2.
  16. Kedir M, Tesfamichael T. Pattern of intussusception at Gondar, Ethiopia. East Afr Med J. 1998 Jan;75(1):2–3.
  17. Ezomike UO, Ituen MA, Ekpemo CS. Indications and outcome of childhood preventable bowel resections in a developing country. Afr J Paediatr Surg. 2014 Jun;11(2):97–100.
  18. A Waldeyes, VonSchreeb T. Intussusception in Ethiopia. Ethiopian Medical Journal. 1972;10:95–103.
  19. Acute intussusception in infants and children Incidence, clinical presentation and management: a global perspective. 1st ed. Geneva Switzerland: World Health Organization; 2002.
How to Cite
Belachew, A. G., Tadesse, A., & Bogale, B. H. (2016). PATTERNS AND SEASONAL VARIATION OF INTUSSUSCEPTION IN CHILDREN: A RETROSPECTIVE ANALYSIS OF CASES OPERATED IN A TERTIARY HOSPITAL IN ETHIOPIA. Ethiopian Medical Journal, 54(1). Retrieved from https://emjema.org/index.php/EMJ/article/view/175

Send mail to Author


Send Cancel