A Retrospective Analysis Of Prevalence And Outcome Of Intussusception In Pediatrics Under Five Years At Jumc, Southwest Ethiopia

Abstract

Background: Intussusception (IS) is one of the most frequent causes of abdominal surgical emergencies in young children. It occurs when one segment of bowel invaginates into the distal bowel, resulting in venous congestion and bowel wall edema progressing to bowel necrosis and gangrene if not treated. The causes of IS are idiopathic in most cases. The purpose of this study is to review the prevalence of acute intussusception in under five years in JUMC and to analyze the mode and outcomes of treatment Methods: This is a four-year retrospective study of children aged under five years who were admitted and treated for intussusception between January 2013 to January 2016 GC at JUMC, southwest, Ethiopia. Information on the patients’ demographic characteristics, clinical presentation, and month of occurrence as well as the operative findings and outcome were obtained from patient charts and the operating theatre registry. Data was collected using checklist developed for this purpose and entered and analyzed by SPSS version 23.0 software Results: One hundred and nineteen cases of intussusception were admitted to JUMC over a four year period (January 2013 to January 2016 GC), of which 106 charts were retrieved and analyzed. Males dominated in the series. Age distribution showed that 63.2% were infants (<1years) and 83% of the cases were children < 2years of age. Abdominal pain (100%), vomiting (83.9%), bloody mucoid diarrhea (63.2%) and a mass palpated abdominally and/or rectally (12.3%) were the most common modes of presentations, with the classic triad of abdominal pain, vomiting and bloody mucoid diarrhea occurring in almost half of the cases (56.6%). The highest peak of presentation was in the months of February to April with 40(37.7%) cases and in the months of July to August with 22(20.7%) cases. Most patients presented to our hospital after 24 hours of onset of illness and most of them were from around Jimma town. Intraoperative, it was found that ileocolic intussusception was the most common type and 103 patients (97.2%) had no pathologic lead point (idiopathic) while only 3 cases (2.8%) had pathologic lead point. 68(64.2%) patients had successful simple reduction. Post-operative complications occurred in 33(31.1 %) patients the most common of which was surgical site infection 14(13.2 %) and there were 10 deaths. Conclusion: Intussusception was more common in infants and majority of them presented during the dry and wet season of the year. There was delayed presentation especially for those coming outside of Jimma town with proportional increase in rate of operative management and bowel resection and complications.