%0 Journal Article
%T Invaginaci¨®n intestinal en pacientes pedi¨¢tricos en el Estado Carabobo
%A Mar¨ªa Tomat
%A Bel¨¦n Salinas
%A Mercedes R. de Materan
%A Rosabel Gonz¨¢lez
%J Salus Online
%D 2009
%I Facultad de Ciencias de la Salud, Universidad de Carabobo
%X Intussusception is a low-frequency pediatric pathology although very important due to its association with the first commercial rotavirus vaccine, which was withdrawn from the market for this reason. Before a possible application of a new vaccine, it was necessary to find out the incidence of intussusception in Carabobo State. Objective: To determine the epidemiology and clinical intussusception in pediatric patients hospitalized in public and private institutions of Carabobo State, Venezuela during 1998-2005. Materials and methods: A retrospective review of the medical records of intussusception patients hospitalized in public and private health centers of Carabobo State between 1998 and 2001, and a prospective one from 2002 - 2005. Results: A total of 159 cases, 89% < 1 year of age, 71% male, 69% from working and marginal social classes (Graffar IV and V). 90% from the Carabobo State, and 10% from other states: 63% Falcon, 25% Cojedes, and 12% Yaracuy. 86% of the children were attended in public health centers (88% in the Children¡¯s Hospital "Dr. JorgeLizarraga¡°, at the Hospital City Enrique Tejera, ¡°CHET") and 14% in private centers. 95% were eutrophic; lethality was 3%. 90% had blood in stools, 88% vomiting and 57% abdominal pain. The rate of intussusception between 1998 and 2005 was 47 per 100,000 live-born children. Ileo-colic intussusception was the most frequent one (27%), ileocecocolic 20%, ileocecal and ileoileal 9% each. Resolution was: 89% surgical, 8% by barium enema, 1% spontaneous. Viral tests were done in 72 children, and coproculture in 68 with the following results: adenovirus 27%, rotavirus 4%, campylobacter spp 4%, Aeromones spp 4%, Enteropathogenic Echerichia Coli (ECEP) 3%, Shigella spp 4%. Conclusions: Intussusception is the most common cause of acute intestinal obstruction in infants <1 year of age. While it has been associated with many ethiologies (e.g, adenovirus or Meckel diverticulum), its cause is mostly unknown. Data from rotavirus surveillance and baseline intussusception must be used to determine the rate of intussusception in each country, and whether there is an association between a rotavirus vaccine and intussusception, through a careful assessment of cases arising after vaccination compared with the expected number of cases. The rate of intussusception found in Carabobo State (47 per 100,000 NVR) is important for assessing adverse events after commercialization of a vaccine. No coincidence was seen in the seasonality observed in the cases of rotavirus and the cases of intussusception studied.
%K Intussusception
%K intestinal invagination
%U http://salus-online.fcs.uc.edu.ve/invaginacion_intestinal_pediatricos.pdf