Omogiade Ernest Udefiagbon, Osahon Otaigbe

Abstract

Background: In a budding paediatric surgery unit of a rural tertiary centre, it is necessary to study the pattern of presentation, management and outcome of childhood intussusception considering its surgical significance. This formed the basis of this study.

Methods: This was a cross-sectional study in which all patients within the paediatric age group (0 – 17 years) managed for intussusception between September 1st, 2014 and August 31st 2021 in the paediatric surgery unit were reviewed. Data collected were analysed as frequencies and proportions using IBM SPSS Statistics version 21. The results were presented in tables, bar charts and pie charts where applicable.

Results: Thirty-nine patients were managed for intussusception with 20 males (51.3%) and 19 females (48.7%). Majority of patients (87.2%) were under 1 year old with six-month old infants mostly affected. More patients (25, 64.1%) presented after one day of onset of symptoms. The highest number of case presentations occurred in the month of December (6, 15.4%), followed by August (5, 12.8%). Twelve cases (30.8%) were initially managed as bacteria dysentery (gastroenteritis) before referral. Twenty-seven patients (69.2%) presented with the classical triad of vomiting, colicky abdominal pain and red currant jelly stools. The typical sausage-shaped mass was demonstrated in 21 patients (53.8%) and 10 patients (25.6%) among the late presenters had features of shock at presentation. Only one patient (2.6%) had prolapsed intussusception in the study. Almost all patients had operative treatment (37, 94.9%) with bowel resection and anastomosis done for 15 (38.5%). Fewer patients (11, 28.2%) had post-operative complications of which most were site infection 5 (45.5%). Number of mortalities was 2 (5.1%).

Conclusion: Continuous medical education on intussusception is required for health care workers in the rural setting as well as orientation of the populace to ensure early presentation of cases. This coupled with provision of facilities for non-operative treatment of intussusception will improve outcome in rural tertiary centres.

Keywords: Childhood, Intussusception, Presentation, Management, Outcome.