Childhood Intussusception: Delayed Presentation and Surgical Outcome

OBJECTIVE: To compare the clinical presentation and surgical outcome in early versus delayed presentation of childhood intussusceptions. METHOD AND MATERIAL: This comparative study was conducted in the Department of Pediatric Surgery, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad from January 2005 to July 2007.All the diagnosed patients of intussusception were categorized into early and delayed group (patient presented later than 24 hours from the onset of first symptom). Data regarding age, sex, clinical presentation, duration of presentation (early or late), surgical findings, treatment and complications were recorded on proforma. All patients of intussusceptions were subjected to laparotomy due to non-availability of image intensifier. Parameters including clinical presentations, surgical findings, treatment options and compliations were analyzed with SPSS version 16. RESULTS: This study was comprised of 80 patients; males 57(71.3%) and females 23(28.7%) with male: female ratio 2.5:1.Early presenting patients were 10 and delayed presenting were 70. Major clinical symptoms were pain in abdomen, vomiting and bleeding per rectum. Significant difference found in early and delayed presenting group was in bleeding per rectum (P<0.001), mass per rectum (P=0.001), mass per abdomen (P=0.029), fever (P=0.006) and abdominal distension (P=0.001). Gangrene of bowel, complications and mortality were more common in delayed presenting group. CONCLUSION: Pain in abdomen, disarrhea and vomiting were almost same in both groups, while distension of abdomen, palpable mass per rectum, bleeding per rectum, mass per abdomen, and fever had significant variability in both groups. There was also high morbidity in delayed presenting group. Early diagnosis and early treatment are main keys to curtail the morbidity and mortality in childhood intussusceptions.