Childhood Intussusception in Ilorin: A Revisit

Abstract Background: Results: Intussusception is the commonest cause of intestinal obstruction in infants worldwide. Whereas the outcome has tremendously improved in the developed countries, the same cannot be said in developing countries, especially Africa. This study aims to review the pattern of presentation and the treatment outcome in patients managed for intussusception at University of Ilorin Teaching Hospital, Ilorin. Patients and Methods: Results:This was a six-year retrospective study of 44 consecutive children aged 15 years old and below, who were managed for intussusception between January 1999 and December 2004, at the University of Ilorin Teaching Hospital, Ilorin. The biodata, clinical presentation, operative findings and outcome were collected from the paediatric surgical unit record book, the operating theatre records and case notes. The data were analyzed using Microsoft Excel and SPSS software. Results:There were 44 patients, 23 males and 21 females (M:F=1.1:1). Their age ranged from 2.5months to 9 years, with a median age of 5 months. The peak age group was 3-6months (30, 68.2%). Thirty-seven (84.1%) patients were within one year of age.The duration of symptoms ranged between 6 hours and four weeks (median = 3.4 days). Majority (72.7%) of patients presented after 48 hours of onset of symptoms, while only 11.4% presented within 24 hours. Vomiting occurred in 97.6%, and abdominal mass in 72.1%. Pain, irritability and excessive cry occurred in 81.4%, while blood in stool was present in 88.4%. Diarrhoea, constipation, pyrexia and abdominal distention were other features in less than half of the patients. Thirty nine patients (88.6%) had emergency laparotomy, at which 51.3% had manual reduction of intussusception, while 48.9% had bowel resection. Ileo-colic intussusception was the most common variety seen. Three of 4 patients with pathologic lead points were above 3 years of age. Eleven patients died, with a post operative mortality of 20.5%. Conclusion:Infants with intussusception still presented late to the hospital with attendant high complication rate and poor outcome. Intussusception, children, late presentation.