STUDY OF VARIOUS TYPES OF TREATMENT MODALITIES IN CHILDREN WITH INTUSSUSCEPTION

Background:Intussusception is a condition in which one part of gut enters into another part of gut known as telescoping. Ultrasonography of abdomen is highly specific and sensitive for diagnosis. Most of the ileo-ileal and fewer ileo-colic intussusceptions may reduce spontaneously. Ultrasound guided reduction is an alternative to surgery. If intussusception is not treated timely it may cause intestinal ischemia, gangrene, perforation peritonitis, shock and death.

Method:This is a hospital based prospective study including 96 patients over a period of 18 months. Detailed proforma was used, including name, age, sex, weight, presenting complaints, duration of complaints, abdominal sign & symptoms, signs of the sepsis & shock, peritonitis, perforation, USG finding, and type of surgery performed. The presence of the complications also noted.

Results:Maximum patients (63.5%) of intussusception diagnosed were between 6 months to two years. Out of total 96 patients, 21 were treated by pneumatic reduction successfully. In 46 patient exploratory laparotomy and intra-operative reduction done, while in 29 children required resection anastomosis. Most common complaint was abdominal pain (100%) followed by Excessive cry (92.7%). Most common type of intussusception was Ileo-colic(88.5%). Respiratory distress (23.9%) followed by septicemia (20.8%) was the most common complications.  

Conclusions:Intussusception is a common surgical problem in childhood. Children of age 6 month to 2 years of age are affected most commonly. Ileo-colic is the most common type. Ultrasonography is diagnostic as well as therapeutic tool for intussusception. USG guided pneumatic reduction is a simple and good technique, if patient comes to hospital earlier. Early diagnosis of signs and symptoms may help clinician to take early interventions to save the gut as well life of the patient.